· Web viewHospital Events 2008/09 and 2009/10 Citation: Ministry of Health. 2012. Hospital Events 2008/09 and 2009/10. Wellington: Ministry of Health. Published in November 2012

Hospital Events2008/09 and 2009/10

Citation: Ministry of Health. 2012. Hospital Events 2008/09 and 2009/10. Wellington: Ministry of Health.

Published in November 2012 by theMinistry of Health

PO Box 5013, Wellington 6145, New Zealand

ISBN 978-0-478-40209-4 (print)ISBN 978-0-473-40210-0 (online)

HP 5584

This document is available at www.health.govt.nz

This work is licensed under the Creative Commons Attribution 4.0 International licence. In essence, you are free to: share ie, copy and redistribute the material in any medium or format; adapt ie, remix, transform and build upon the material. You must give appropriate credit, provide a link to the licence and indicate if changes were made.

AcknowledgementsMany people have assisted in the production of this publication. In particular, the Ministry of Health thanks the peer reviewers for their valuable contribution.

SourceHospital data for this publication are sourced from the National Minimum Dataset held by the Ministry of Health.

DisclaimerThe purpose of this publication is to inform discussion and assist policy development. The opinions expressed in the publication do not necessarily reflect the official views of the Ministry of Health.

All care has been taken in the production of this publication. The data are deemed to be accurate at the time of publication, but may be subject to slight changes over time as further information is received. It is advisable to check the current status of figures given here with the Ministry of Health before quoting or using them in further analysis.

National collection, coding and collation of hospital event data is a complex process. This is because the information in the National Minimum Dataset cannot be finalised until data have become available from all hospitals that report to the Ministry of Health. In addition, several steps are required to ensure the final information is of good quality.

The Ministry of Health makes no warranty, expressed or implied, nor assumes any legal liability or responsibility for the accuracy, correctness, completeness or use of the information or data in this publication. Further, the Ministry of Health shall not be liable for any loss or damage arising directly or indirectly from the information or data presented in this publication.

The Ministry of Health welcomes comments and suggestions about this publication.

iv Hospital Events 2008/09 and 2009/10

Hospital Events 2008/09 and 2009/10 v

ContentsKey points xi

Introduction 1Purpose 1Data sources, data quality and timing issues 1

Hospital discharges 4Overview 4Sex 5Age 8Ethnicity 12Deprivation 18District health board region 20Selected diagnoses 27Length of stay and bed days 35Inpatients and day cases 39

Hospital procedures 46Overview 46Sex 46Age 48Ethnicity 53Deprivation 59District health board region 61Selected procedures 67Length of stay 73Inpatients and day cases 76

Hospital discharges involving injury and poisoning 83Overview 83Sex 84Age 86Ethnicity 88Deprivation 94District health board region 96Selected causes 102Length of stay and bed days 105

vi Hospital Events 2008/09 and 2009/10

Inpatients and day cases 110

Further hospital-related information 115Electronic version of this Hospital Events publication 115Other hospital-related Ministry of Health publications 115Other publications containing data from the National Minimum Dataset116Other hospital-related publications 116Population and demographic data 116Hospital data available from the Ministry of Health 117Additional information available from the Ministry of Health 118

Definitions 119

Technical notes 122Rate calculations 122Confidence intervals 124Procedure codes 124

References 126

List of tablesTable 1: Hospital discharges by hospital type and funding type, 2004/05–

2009/10 2Table 2: Hospital discharges and age-standardised rates by sex, 1995/96–

2009/10 6Table 3: Publicly funded hospital discharges by five-year age group and

sex, 2009/10 8Table 4: Privately funded hospital discharges by five-year age group and

sex, 2009/10 9Table 5: Publicly funded hospital discharges and age-standardised rates by

ethnicity, 1995/96–2009/10 12Table 6: Publicly funded hospital discharges and age-standardised rates by

ethnicity and sex, 1995/96–2009/10 14Table 7: Publicly funded hospital discharges by DHB region, 2009/10 21Table 8: Publicly funded hospital discharges by DHB region, Māori

population, 2009/10 24Table 9: Age-standardised publicly funded hospital discharge rates for

selected diagnoses by sex and ethnicity, 2009/10 29Table 10: Age-standardised privately funded hospital discharge rates for

selected diagnoses by sex, 2009/10 33Table 11: Average length of stay and total bed days by sex and ethnicity,

publicly funded hospital discharges, 1995/96 and 2009/10 35

Hospital Events 2008/09 and 2009/10 vii

Table 12: Average length of stay and total bed days by sex, privately funded hospital discharges, 2004/05 and 2009/10 36

Table 13: Average length of stay and total bed days by DHB region, total population, publicly funded hospital discharges, 2009/10 37

Table 14: Average length of stay and total bed days by DHB region, Māori population, publicly funded hospital discharges, 2009/10 38

Table 15: Hospital discharges by patient type, 1995/96–2009/10 39Table 16: Hospital procedures and age-standardised rates by sex, 1995/96–

2009/10 47Table 17: Publicly funded hospital procedures by five-year age group and

sex, 2009/10 49Table 18: Privately funded hospital procedures by five-year age group and

sex, 2009/10 50Table 19: Publicly funded hospital procedures and age-standardised rates

by ethnicity, 1995/96–2009/10 53Table 20: Publicly funded hospital procedures and age-standardised rates

by ethnicity and sex, 1995/96–2009/10 55Table 21: Publicly funded hospital procedures by DHB region, 2009/10 61Table 22: Publicly funded hospital procedures by DHB region, Māori

population, 2009/10 64Table 23: Age-standardised publicly funded hospital procedure rates for

selected procedures by sex and ethnicity, 2009/10 68Table 24: Age-standardised privately funded hospital procedure rates for

selected procedures by sex, 2009/10 71Table 25: Average length of stay and total bed days by sex and ethnicity,

publicly funded hospital procedures, 1995/96 and 2009/10 73Table 26: Average length of stay and total bed days by sex and ethnicity,

privately funded hospital procedures, 2004/05 and 2009/10 73Table 27: Average length of stay by ethnicity and DHB region, publicly

funded hospital procedures, 2009/10 75Table 28: Hospital procedures by patient type, 1995/96–2009/10 76Table 29: Hospital discharges involving injury and poisoning and age-

standardised rates by sex, 1995/96–2009/10 84Table 30: Hospital discharges involving injury and poisoning by five-year

age group and sex, 2009/10 86Table 31: Hospital discharges involving injury and poisoning and age-

standardised rates by ethnicity, 1995/96–2009/10 88Table 32: Hospital discharges involving injury and poisoning and age-

standardised rates by ethnicity and sex, 1995/96–2009/10 90Table 33: Hospital discharges involving injury and poisoning by DHB

region, 2009/10 96Table 34: Hospital discharges involving injury and poisoning by DHB

region, Māori population, 2009/10 99Table 35: Age-standardised rates for hospital discharges involving injury

and poisoning for selected causes by sex and ethnicity, 2009/10102Table 36: Average length of stay and total bed days by sex and ethnicity,

hospital discharges involving injury and poisoning, 1995/96 and

viii Hospital Events 2008/09 and 2009/10

2009/10 105Table 37: Average length of stay and total bed days by DHB region, total

population, hospital discharges involving injury and poisoning, 2009/10 108

Table 38: Average length of stay and total bed days by DHB region, Māori population, hospital discharges involving injury and poisoning, 2009/10 109

Table 39: Hospital discharges involving injury and poisoning by patient type,1995/96–2009/10 110

Table N-1: Population data, 2009/10 122Table N-2: World Health Organization world standard population 123Table N-3: ICD-10-AM 6th Edition procedure codes for selected procedures124

List of figuresFigure 1: Number of hospital discharges by hospital type and funding type,

2009/10 2Figure 2: Number of patients discharged from hospital by funding type,

2009/10 5Figure 3: Age-standardised hospital discharge rates by sex, 1999/00–

2009/10 7Figure 4: Age-specific publicly funded hospital discharge rates by sex,

2009/10 10Figure 5: Age-specific privately funded hospital discharge rates by sex,

2009/10 11Figure 6: Age-standardised publicly funded hospital discharge rates by

ethnicity, 1999/00–2009/10 13Figure 7: Age-specific publicly funded hospital discharge rates by ethnicity,

2009/10 15Figure 8: Age-specific publicly funded hospital discharge rates by ethnicity,

males, 2009/10 16Figure 9: Age-specific publicly funded hospital discharge rates by ethnicity,

females, 2009/10 17Figure 10: Publicly and privately funded hospital discharge rates by

deprivation quintile, 2009/10 18Figure 11: Publicly funded hospital discharge rates by ethnicity and

deprivation quintile, 2009/10 19Figure 12: Publicly funded hospital discharge rates by DHB region, 2009/1022Figure 13: Publicly funded hospital discharge rates by DHB region, 2009/1023Figure 14: Publicly funded hospital discharge rates by DHB region, Māori

population, 2009/10 25Figure 15: Publicly funded hospital discharge rates by DHB region, Māori

population, 2009/10 26Figure 16: Publicly funded hospital discharges by sex and ICD chapter,

2009/10 27

Hospital Events 2008/09 and 2009/10 ix

Figure 17: Privately funded hospital discharges by sex and ICD chapter, 2009/10 32

Figure 18: Age-specific publicly funded hospital discharge rates by patient type, 2009/10 40

Figure 19: Age-specific privately funded hospital discharge rates by patient type, 2009/10 41

Figure 20: Age-specific publicly funded hospital discharge rates by ethnicity, inpatients, 2007/08 42

Figure 21: Age-specific publicly funded hospital discharge rates by ethnicity, day cases, 2009/10 43

Figure 22: Publicly funded hospital discharges by deprivation quintile and patient type, 2009/10 44

Figure 23: Privately funded hospital discharges by deprivation quintile and patient type, 2009/10 45

Figure 24: Age-standardised hospital procedure rates by sex, 1999/00–2009/10 48

Figure 25: Age-specific publicly funded hospital procedure rates by sex, 2009/10 51

Figure 26: Age-specific privately funded hospital procedure rates by sex, 2009/10 52

Figure 27: Age-standardised hospital procedure rates by ethnicity, 1999/00–2009/10 54

Figure 28: Age-specific publicly funded hospital procedure rates by ethnicity, 2009/10 56

Figure 29: Age-specific publicly funded hospital procedure rates by ethnicity, males, 2009/10 57

Figure 30: Age-specific publicly funded hospital procedure rates by ethnicity, females, 2009/10 58

Figure 31: Publicly and privately funded procedure rates by deprivation quintile, 2009/10 59

Figure 32: Publicly funded hospital procedure rates by ethnicity and deprivation quintile, 2009/10 60

Figure 33: Publicly funded hospital procedure rates by DHB region, 2009/1062Figure 34: Publicly funded hospital procedure rates by DHB region, 2009/1063Figure 35: Publicly funded hospital procedure rates by DHB region, Māori

population, 2009/10 65Figure 36: Publicly funded hospital procedure rates by DHB region, Māori

population, 2009/10 66Figure 37: Publicly funded hospital procedures by sex and ICD chapter,

2009/10 67Figure 38: Privately funded hospital procedures by sex and ICD chapter,

2009/10 70Figure 39: Average length of stay, hospital procedures, 2009/10 74Figure 40: Age-specific publicly funded hospital procedure rates by patient

type, 2009/10 77Figure 41: Age-specific privately funded hospital procedure rates by patient

type, 2009/10 78

x Hospital Events 2008/09 and 2009/10

Figure 42: Age-specific publicly funded hospital procedure rates by ethnicity, inpatients, 2009/10 79

Figure 43: Age-specific publicly funded hospital procedure rates by ethnicity, day cases, 2009/10 80

Figure 44: Publicly funded hospital procedures by deprivation quintile and patient type, 2009/10 81

Figure 45: Privately funded hospital procedures by deprivation quintile and patient type, 2009/10 82

Figure 46: Age-standardised hospital discharge rates involving injury and poisoning by sex, 1995/96–2009/10 85

Figure 47: Age-specific rates for hospital discharges involving injury and poisoning by sex, 2009/10 87

Figure 48: Age-standardised rates for hospital discharges involving injury and poisoning by ethnicity, 1999/00–2009/10 89

Figure 49: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, 2009/10 91

Figure 50: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, males, 2009/10 92

Figure 51: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, females, 2009/10 93

Figure 52: Rates for hospital discharges involving injury and poisoning by deprivation quintile, 2009/10 94

Figure 53: Rates for hospital discharges involving injury and poisoning by ethnicity and deprivation quintile, 2009/10 95

Figure 54: Hospital discharges involving injury and poisoning by DHB region, 2009/10 97

Figure 55: Hospital discharges involving injury and poisoning by DHB region, 2009/10 98

Figure 56: Hospital discharges involving injury and poisoning by DHB region, Māori population, 2009/10 100

Figure 57: Hospital discharges involving injury and poisoning by DHB region, Māori population, 2009/10 101

Figure 58: Average length of stay by deprivation quintile, hospital discharges involving injury and poisoning, 2009/10 106

Figure 59: Total bed days by deprivation quintile, hospital discharges involving injury and poisoning, 2009/10 107

Figure 60: Age-specific rates for hospital discharges involving injury and poisoning by patient type, 2009/10 111

Figure 61: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, inpatients, 2009/10 112

Figure 62: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, inpatients, 2009/10 113

Figure 63: Hospital discharges involving injury and poisoning by deprivation quintile and patient type, 2009/10 114

Hospital Events 2008/09 and 2009/10 xi

Key pointsOverviewHospital discharges

There were more than 1.1 million discharges from New Zealand hospitals in 2009/10. This equates to 21,794.8 publicly funded hospitalisations per 100,000 people and 1407.7 privately funded hospitalisations per 100,000 people (age-standardised).

There were 310 more publicly funded hospitalisations and 147 fewer privately funded hospitalisations per 100,000 people in 2009/10 compared with 2008/09.

Hospital procedures

More than 1.5 million procedures were performed in New Zealand hospitals in 2009/10. Relative to the population, there were 28,617.5 publicly funded procedures and 2926.8 privately funded procedures per 100,000 people (age-standardised).

There were 1449 more publicly funded procedures and 336 fewer privately funded procedures per 100,000 people in 2009/10 compared with 2008/09.

Hospital discharges involving injury and poisoning

There were 180,042 discharges involving injury and poisoning from New Zealand hospitals in 2009/10. This equates to 3595.1 hospitalisations per 100,000 people (age-standardised).

There were 87 more hospitalisations involving injury and poisoning per 100,000 people in 2009/10 compared with 2008/09.

Sex In 2009/10 there were:

– 79 male hospitalisations for every 100 female hospitalisations– 80 male procedures for every 100 female procedures– 112 male hospitalisations involving injury and poisoning for every 100

female hospitalisations.

xii Hospital Events 2008/09 and 2009/10

In 2009/10, females had higher age-standardised rates of hospital discharges and hospital procedures compared with males, while males had a higher rate of hospitalisations involving injury and poisoning compared with females.

Age Generally, older patients (aged 65 years and over) had higher rates of

hospital discharges, procedures and hospitalisations involving injury and poisoning compared with other age groups in 2009/10.

Young patients aged 0–4 years and females aged 15–49 years also had higher hospitalisation and procedure rates compared with other age groups in 2009/10.

Ethnicity In 2009/10 Māori accounted for:

– 16 out of every 100 publicly funded hospital discharges– 15 out of every 100 publicly funded hospital procedures– 15 out of every 100 hospitalisations involving injury and poisoning.

Māori had higher rates of publicly funded hospital discharges, hospital procedures and hospitalisations involving injury and poisoning compared with non-Māori in each year from 1995/96 to 2009/10.

Deprivation As deprivation increased, rates of publicly funded hospital discharges,

procedures and hospitalisations involving injury and poisoning increased in 2009/10.

As deprivation increased, rates of privately funded hospital discharges and procedures decreased in 2009/10.

At all levels of deprivation Māori had higher rates of publicly funded hospital discharges, hospital procedures and hospitalisations involving injury and poisoning compared with non-Māori in 2009/10.

District health board region Over half of North Island DHB regions and one South Island DHB region

had significantly higher hospitalisation rates compared to the New Zealand rate in 2009/10.

Hospital Events 2008/09 and 2009/10 xiii

The majority of North Island DHB regions and half of South Island DHB regions had significantly higher procedure rates compared to the national rate in 2009/10.

Nearly two-thirds of North Island DHB regions had significantly higher rates for hospitalisations involving injury and poisoning compared to the New Zealand rate in 2009/10.

Selected diagnoses and procedures For most selected diagnoses (including those for hospitalisations

involving injury and poisoning), male hospitalisation rates were higher than female rates in 2009/10.

For the majority of selected procedures and selected diagnoses (including those for hospitalisations involving injury and poisoning), Māori had higher rates compared with non-Māori in 2009/10.

Length of stay and bed days The average length of stay increased for hospital discharges and

decreased for both procedures and hospitalisations involving injury and poisoning from 1995/96 to 2009/10.

On average, non-Māori hospitalisations (including those involving injury and poisoning) were longer than those of Māori in 2009/10. However, for hospital procedures, Māori spent slightly longer (on average) in hospital compared with non-Māori.

Compared with publicly funded patients, the average length of stay was:– longer for privately funded hospitalisations in 2009/10– shorter for privately funded procedures in 2009/10.

From 1995/96 to 2009/10 the total number of bed days increased by:– nearly 2 million (or 56.9%) for publicly funded hospital discharges– almost 400,000 (or 57.5%) for hospitalisations involving injury and

poisoning.

The total number of bed days increased by over 80,000 (or 20.9%) for privately funded hospitalisations from 2004/05 to 2009/10.

Inpatients and day cases In 2009/10, day cases accounted for:

– one out of every three publicly funded hospital discharges– one out of every three publicly funded procedures– one out of every four hospitalisations involving injury and poisoning.

xiv Hospital Events 2008/09 and 2009/10

Day cases accounted for more than half of all:– privately funded hospital discharges (56.0%)– privately funded hospital procedures (54.7%) in 2009/10.

Hospital Events 2008/09 and 2009/10 xv

IntroductionPurposeThe purpose of this Hospital Events publication series is to inform discussion and assist in future policy development. Readership of this publication is wide ranging, and its contents reflect this, aiming to meet the needs of all interested parties.

This publication contains statistical information about events1 in New Zealand hospitals, including: discharges (hospitalisations) from publicly and privately funded facilities procedures performed in publicly and privately funded facilities discharges involving injury and poisoning.

While this publication focuses on hospital events that occurred in the 2008/09 and 2009/10 years, it also contains time trends from 1995/96 onwards.

Data sources, data quality and timing issuesThe National Minimum DatasetThe data in this publication is from the National Minimum Dataset (NMDS), a national collection of public and private hospital discharge information (including clinical information) for inpatients and day patients. The NMDS collects and stores unit record data. It is important to note that hospital events recorded in the NMDS represent individual events rather than individual people. The number of events will be higher than the number of people, because one person can contribute numerous unique hospital events to the dataset.

The information presented in this publication is reported by financial year ended 30 June. For example, the 2009/10 financial year relates to the period from 1 July 2009 to 30 June 2010.

The publication covers both publicly and privately funded hospital events. Publicly funded events2 can occur in public or private hospitals, just as

1 Hospital events include those involving New Zealand and overseas residents treated in New Zealand.

2 Publicly funded events include Accident Compensation Corporation (ACC), DHB and Ministry of Health funded events.

Hospital Events 2008/09 and 2009/10 1

privately funded events can occur in private or public hospitals. Figure 1 and Table 1 illustrate this point.

Figure 1: Number of hospital discharges by hospital type and funding type, 2009/10Public hospitals

972,224

3,679

Publicly fundedPrivately funded

Private hospitals

63,730

67,557

Source: National Minimum Dataset

Table 1 shows that for the six years to 30 June 2010, the majority of discharges from public hospitals were publicly funded. Over half of reported discharges from private hospitals3 were privately funded.

3 In this publication, ‘private hospitals’ include private surgical hospitals and private aged care facilities.

2 Hospital Events 2008/09 and 2009/10

Table 1: Hospital discharges by hospital type and funding type, 2004/05–2009/10

Year Hospital type Number of discharges Percent of total discharges

Funding type Funding type

Public Private Public Private

2004/05 Public 812,566 2944 84.9 0.3

Private 57,786 83,903 6.0 8.8

2005/06 Public 837,983 2743 85.8 0.3

Private 55,254 80,868 5.7 8.3

2006/07 Public 864,405 3082 85.8 0.3

Private 61,388 78,721 6.1 7.8

2007/08 Public 867,932 3550 86.3 0.4

Private 65,211 68,612 6.5 6.8

2008/09 Public 935,305 3101 86.9 0.3

Private 64,277 73,682 6.0 6.8

2009/10 Public 972,224 3679 87.8 0.3

Private 63,730 67,557 5.8 6.1


It is important to note that the private hospital data in this publication is not complete, as not all private hospitals report their data to the Ministry of Health. The following section provides information on the quality of hospital data.

Quality of publicly funded hospital dataThis publication contains publicly funded hospital data for the financial years from 1995/96 to 2009/10 (1 July 1995 to 30 June 2010). Improvements in the recording and reporting of data from July 1995 have enabled meaningful analysis from that point onward.


Quality of privately funded hospital dataThis publication contains privately funded hospital data for the financial years from 2004/05 to 2009/10 (1 July 2004 to 30 June 2010). Data has been used from 2004/05 onwards because the completeness of privately funded and privately provided hospital data improved from that point.

The privately funded hospital data included in this publication are not complete, as not all private hospitals report their data to the Ministry of Health. In 2010, for example, 10 hospitals reported no data, and two hospitals sent data to the Ministry of Health with some months missing. In 2009, four hospitals reported no data and nine hospitals reported incomplete data. The Ministry of Health has no means of accurately assessing the number and nature of discharge data that are not reported. For these reasons, regional comparisons of privately funded hospital data are not included in this publication.

Other aspects affecting the quality of privately funded data are ethnicity and diagnosis information. Ethnicity data for private hospitals have not been included in this publication due to the high number of events that have no ethnicity information recorded. Diagnosis information is more complete for medical discharges than for surgical data due to more complete reporting.

The strengths of the privately funded hospital data include procedure information, length of stay and patient details.

In summary, care should be taken when analysing the privately funded hospital data in this publication, because they do not present a complete dataset.

Timing of dataThe timeliness of all hospital discharge information is improving and will continue to do so. The Ministry of Health conducts data quality work after public and private hospital data are coded. Once this process is complete, provisional hospital data is made available via the Ministry of Health’s website. More detail can be found in the ‘Further hospital-related information’ section towards the end of this publication.


Hospital dischargesThis chapter presents statistics on discharges from publicly and privately funded New Zealand hospitals. Note that information is presented according to the number of hospital discharges, rather than the number of patients. The number of discharges will be higher than the number of patients, because one person can be hospitalised more than once in a given year.

OverviewThere were 1,107,190 reported discharges4 from New Zealand hospitals in 2009/10. Publicly funded hospitalisations made up the majority of total hospital discharges in 2009/10 – 93.6% of hospital discharges were publicly funded.

Over the past six years, the number of publicly funded hospital discharges increased by 19.0%, while the number of reported privately funded hospital discharges decreased by 18.0%.

The number of publicly funded hospitalisations relative to the population5 was 21,794.8 per 100,000 in 2009/10. In the same year, there were 1407.7 privately funded hospitalisations per 100,000 people (Table 2).

Compared with 2008/09, there were 310 more publicly funded hospitalisations and 147 fewer privately funded hospitalisations per 100,000 people in 2009/10.

Compared with privately funded patients, it is more common for publicly funded patients to be hospitalised more than once in any given year. In 2009/10, 59.1% (611,937) of publicly funded hospitalisations were for patients who were treated more than once (in either a public or private hospital). In the same year, 18.2% (12,949) of privately funded hospitalisations were for patients who were treated more than once (in either a private or public hospital).

4 Hospital discharges (hospitalisations) include day patients, transfers and readmissions.

5 An age-standardised rate is a rate that has been adjusted to take account of differences in the age distribution of the population over time or between different groups (for example, different ethnic groups). This publication has used the WHO world standard population in determining age-standardised rates. For more information on rates refer to the ‘Definitions’ section of this publication.


In 2009/10, 680,787 people were discharged 1,107,190 times from New Zealand hospitals. Figure 2 shows that almost 11,379 patients received both publicly funded and privately funded treatment during this year. It is important to note that a single person can contribute many unique hospital events in any particular year.

Figure 2: Number of patients discharged from hospital by funding type, 2009/10

616,583patients that only received publicly funded treatment

52,825 patients that only received privately funded treatment

patients that received both publicly funded and

privately funded treatment in 2009/10

11,379


SexEach year more females than males are discharged from New Zealand hospitals. There were 79 male hospitalisations for every 100 female hospitalisations in 2009/10. In this year, females accounted for 55.8% of all publicly funded and privately funded hospitalisations. Maternity-related events accounted for almost one in five of these female hospitalisations. Please refer to the ‘Selected diagnoses’ section in this chapter for further information.


Table 2 shows the number of hospital discharges and age-standardised rates by sex for the period from 1 July 1995 to 30 June 2010. In 2009/10, 617,337 females and 489,853 males were discharged from public and private hospitals. Accounting for changes in the New Zealand population, the rate of publicly funded hospitalisations increased by 30.7% from 1995/96 to 2009/10. The rate of reported privately funded hospitalisations fell by 25.0% from 2004/05 to 2009/10.

Table 2: Hospital discharges and age-standardised rates by sex, 1995/96–2009/10

Publicly funded hospital discharges

Year Male Female Total

Number Rate Number Rate Number Rate

1995/96 276,640 14,621.4 372,851 18,773.5 649,491 16,670.4

1996/97 279,101 14,546.9 372,830 18,480.7 651,931 16,493.8

1997/98 294,257 15,180.3 386,765 19,003.6 681,022 17,072.0

1998/99 306,649 15,682.0 397,546 19,351.1 704,195 17,507.5

1999/00 323,471 16,371.8 420,951 20,334.4 744,422 18,357.6

2000/01 349,893 17,566.3 450,080 21,628.4 799,973 19,608.8

2001/02 364,087 17,963.1 458,298 21,642.0 822,386 19,806.9

2002/03 366,426 17,709.2 461,769 21,387.1 828,195 19,559.0

2003/04 373,481 17,724.0 472,579 21,546.8 846,060 19,651.1

2004/05 387,223 18,036.3 483,129 21,704.0 870,352 19,891.5

2005/06 398,381 18,281.1 494,856 21,951.5 893,237 20,148.6

2006/07 411,247 18,429.4 514,546 22,545.9 925,793 20,512.6

2007/08 412,668 18,151.8 520,475 22,590.3 933,143 20,395.6

2008/09 442,269 19,111.1 557,313 23,816.2 999,582 21,484.7

2009/10 457,160 19,295.6 578,794 24,259.3 1,035,954 21,794.8

Privately funded hospital discharges



2004/05 39,309 1750.1 47,538 2002.4 86,847 1877.5

2005/06 37,649 1639.7 45,962 1894.6 83,611 1769.5

2006/07 37,019 1579.0 44,784 1822.5 81,803 1702.6

2007/08 32,206 1351.6 39,956 1615.6 72,162 1485.9

2008/09 35,982 1489.1 40,801 1618.9 76,783 1554.8

2009/10 32,693 1318.9 38,543 1493.1 71,236 1407.7



Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.

Figure 3 shows that females had a consistently higher rate of publicly funded and privately funded hospitalisations than males from 1999/00 to 2009/10. Over this time period, the rate of publicly funded hospitalisations increased by 19.3% for females and 17.9% for males.

For privately funded facilities, the hospitalisation rate for females and males decreased by 25.4% and 24.6% respectively, from 2004/05 to 2009/10. Some of this decrease is due to the number of privately funded hospitals that report their data to the Ministry of Health (see the ‘Data sources, data quality and timing issues’ section in the Introduction for further information).

Figure 3: Age-standardised hospital discharge rates by sex, 1999/00–2009/10

0

5,000

10,000

15,000

20,000

25,000

30,000

1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10

Year

Female publicly funded hospital discharges

Male publicly funded hospital discharges

Female privately funded hospital discharges

Male privately funded hospital discharges

Age-standardised rate




AgeIn 2009/10, the number of publicly funded hospitalisations was highest in the 0–4 year age group,6 with 143,281 or 13.8% of total discharges (Table 3).

However, those aged 85 years and over had the highest rate7 of publicly funded hospitalisations in 2009/10. In this age group, there were around 97,000 hospitalisations per 100,000 males and around 82,500 hospitalisations per 100,000 females.

Table 3: Publicly funded hospital discharges by five-year age group and sex, 2009/10

Age group (years)

Male Female Total


0–4 77,515 48,440.8 65,766 43,315.6 143,281 45,945.5

5–9 15,995 10,888.4 12,462 8906.5 28,457 9921.6

10–14 13,074 8625.1 10,310 7149.3 23,384 7905.9

15–19 16,653 10,061.6 28,045 17,876.7 44,698 13,864.6

20–24 16,730 10,366.8 41,364 26,887.7 58,094 18,429.7

25–29 13,584 9487.4 43,458 29,923.6 57,042 19,778.1

30–34 13,028 10,073.5 46,381 33,131.7 59,409 22,058.1

35–39 16,643 11,638.5 40,293 25,455.2 56,936 18,897.4

40–44 19,725 13,209.0 27,447 16,900.9 47,172 15,132.3

45–49 23,620 15,127.4 26,225 15,747.9 49,845 15,447.7

50–54 25,020 17,540.7 25,477 17,115.9 50,497 17,324.3

55–59 26,558 21,516.6 25,285 19,767.8 51,843 20,626.6

60–64 31,197 27,586.0 29,167 24,882.3 60,364 26,209.9

65–69 31,628 36,781.0 28,264 31,324.4 59,892 33,987.1

70–74 31,424 47,982.9 29,387 41,123.7 60,811 44,403.8

75–79 32,464 66,415.7 30,285 53,792.2 62,749 59,658.7

80–84 29,108 83,643.7 31,066 67,667.2 60,174 74,555.8

85+ 23,194 97,005.4 38,112 82,529.2 61,306 87,467.5

All ages 457,160 21,316.8 578,794 26,034.3 1,035,954 23,718.0


Note 1: The rates shown are age-specific rates per 100,000 people in each age group. The ‘all ages’ rate is the crude rate.

6 Hospital discharges for children aged 0–4 years include birth events: 30.6% of publicly funded hospital discharges for this age group were for live births in 2009/10.

7 An age-specific rate refers to the frequency with which an event occurs relative to the number of people in a defined age group. In this publication age-specific rates are given in five-year age groups.


Note 2: Hospital discharges for children aged 0–4 years include birth events.

Table 4 shows that the 60–64 year age group had the highest number of privately funded hospitalisations in 2009/10 (7523 or 10.6%), followed by the 55–59 (6753) and 50–54 (6358) age groups (9.5% and 8.9% respectively). This age-related trend has been present each year from 2004/05.

The 85 years and over age group had the highest age-specific rate of privately funded hospitalisations in 2009/10 – 3601.1 hospitalisations per 100,000 people.

Table 4: Privately funded hospital discharges by five-year age group and sex, 2009/10

Age group (years)

Male Female Total


0–4 1978 1236.1 1427 939.9 3405 1091.9

5–9 1096 746.1 778 556.0 1874 653.4

10–14 555 366.1 565 391.8 1120 378.7

15–19 1103 666.4 1325 844.6 2428 753.1

20–24 1186 734.9 1644 1068.6 2830 897.8

25–29 897 626.5 1385 953.7 2282 791.2

30–34 976 754.7 1789 1277.9 2765 1026.6

35–39 1368 956.6 2579 1629.3 3947 1310.0

40–44 1756 1175.9 3044 1874.4 4800 1539.8

45–49 2304 1475.6 3570 2143.8 5874 1820.4

50–54 2762 1936.3 3596 2415.9 6358 2181.3

55–59 3220 2608.8 3533 2762.1 6753 2686.8

60–64 3878 3429.1 3645 3109.5 7523 3266.5

65–69 3202 3723.7 2870 3180.8 6072 3445.7

70–74 2235 3412.7 2095 2931.7 4330 3161.7

75–79 1810 3702.9 1747 3103.0 3557 3381.8

80–84 1334 3833.3 1460 3180.1 2794 3461.8

85+ 1033 4320.4 1491 3228.7 2524 3601.1

All ages 32,693 1524.4 38,543 1733.7 71,236 1630.9


Note: The rates shown are age-specific rates per 100,000 people in each age group. The ‘all ages’ rate is the crude rate.


Figure 4 shows publicly funded hospital discharge rates by five-year age group and sex for 2009/10.

Females had higher hospitalisation rates than males over the child-bearing years(15–49 years).8 For males, the rate of publicly funded hospitalisations generally increased with age from 15 years.

For both males and females, hospitalisation rates peaked in the 85 years and over age group: 97,055.4 per 100,000 males and 82,529.2 per 100,000 females.

Figure 4: Age-specific publicly funded hospital discharge rates by sex, 2009/10

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Age group (years)

Male Female

Age-specific rate


Note: Rates shown are age-specific rates per 100,000 people in each age group.

8 For females aged 15–49 years, hospitalisations relating to pregnancy and childbirth made up 40.3% of total publicly funded hospital discharges in 2009/10.


Figure 5 shows privately funded hospitalisation rates by five-year age group and sex for 2009/10. The trends are similar to those seen for publicly funded hospitalisations in Figure 2, although females did not have such a pronounced increase in rates over the child-bearing years.

The highest rates of hospitalisations for both males and females were in the 85 years and over age group: 4320.4 privately funded hospitalisations per 100,000 males and 3228.7 per 100,000 females.

Figure 5: Age-specific privately funded hospital discharge rates by sex, 2009/10

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Age group (years)

Male Female

Age-specific rate




EthnicityThis section presents ethnicity data for publicly funded hospital discharges only. Ethnicity data for private hospitals cannot be included in this publication due to the high number of discharges that have no ethnicity information recorded (see the ‘Data sources, data quality and timing issues’ section in the Introduction for further information).

Māori accounted for 16.8% (174,427) of publicly funded hospitalisations in 2009/10. According to Statistics New Zealand, Māori made up 15.2% of the New Zealand population at 30 June 2010.9

Table 5 shows that Māori had higher hospitalisation rates compared with non-Māori for each year from 1995/96 to 2009/10. Furthermore, the rate for Māori showed a larger increase compared with non-Māori over the 15 years to 30 June 2010 (48.3% and 27.2% respectively).

Table 5: Publicly funded hospital discharges and age-standardised rates by ethnicity, 1995/96–2009/10

Year Māori discharges Non-Māori discharges

Number Rate Number Rate

1995/96 91,678 18,924.0 557,813 16,549.9

1996/97 93,997 19,092.2 557,934 16,288.2

1997/98 99,811 20,115.2 581,211 16,833.5

1998/99 104,661 20,840.6 599,534 17,229.7

1999/00 112,007 22,025.6 632,415 18,056.0

2000/01 123,037 23,514.5 676,936 19,245.6

2001/02 127,671 24,127.4 694,715 19,396.7

2002/03 132,726 24,859.1 695,469 18,998.9

2003/04 138,571 25,683.8 707,489 18,999.6

2004/05 143,919 26,396.4 726,433 19,161.8

2005/06 150,085 26,989.3 743,152 19,348.7

2006/07 154,931 27,103.6 770,862 19,731.0

2007/08 153,523 25,900.8 779,620 19,739.5

2008/09 167,941 27,612.6 831,641 20,731.4

2009/10 174,427 28,072.1 861,527 21,043.4


9 See http://stats.govt.nz/browse_for_stats/population/estimates_and_projections/maori-population-estimates.aspx and http://stats.govt.nz/browse_for_stats/population/ estimates_and_projections/NationalPopulationEstimates_HOTPJun11qtr.aspx


http://stats.govt.nz/browse_for_stats/population/

http://stats.govt.nz/browse_for_stats/population/estimates_and_projections/maori-population-estimates.aspx

http://stats.govt.nz/browse_for_stats/population/estimates_and_projections/maori-population-estimates.aspx


Figure 6 shows that the greatest disparity between Māori and non-Māori hospitalisation rates occurred in 2005/06. In this year, the rate for Māori was 39.5% higher than the rate for non-Māori. In 2009/10, the hospitalisation rate for Māori was 33.4% higher than the rate for non-Māori.

Hospitalisation rates for Māori were significantly10 higher than rates for non-Māori for each year from 1995/96 to 2009/10.

Compared with 2008/09, there were 459 more Māori hospitalisations (per 100,000 Māori) in 2009/10. Non-Māori had 312 more hospitalisations (per 100,000 non-Māori) in 2009/10 compared with the previous year.

Figure 6: Age-standardised publicly funded hospital discharge rates by ethnicity,1999/00–2009/10

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1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10

Year

Māori

Non-Māori



Note 1: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.

Note 2: The drop in the hospitalisation rate in 2007/08 may be due to administrative reasons such as the under-reporting of short stay emergency department events in some district health boards.

10 Rates were found to be statistically significant using 95% confidence intervals.


Table 6 shows that for both Māori and non-Māori, more females were discharged from hospital than males for each year from 1995/96 to 2009/10. Māori males experienced the greatest increase in rates of hospitalisation (56.7%) over the same time period.

Table 6: Publicly funded hospital discharges and age-standardised rates by ethnicity and sex, 1995/96–2009/10

Year Māori male Māori female Non-Māori male Non-Māori female

Number Rate Number Rate Number Rate Number Rate

1995/96 36,429 15,573.0 55,249 22,004.5 240,211 14,682.1 317,602 18,502.8

1996/97 38,044 16,194.5 55,953 21,771.6 241,057 14,505.5 316,877 18,138.1

1997/98 41,211 17,474.1 58,600 22,590.6 253,046 15,096.3 328,165 18,635.7

1998/99 44,073 18,477.3 60,588 23,055.5 262,576 15,537.3 336,958 18,961.3

1999/00 47,413 19,537.1 64,594 24,334.5 276,058 16,200.6 356,357 19,922.3

2000/01 52,575 20,970.0 70,462 25,886.4 297,318 17,327.6 379,618 21,157.7

2001/02 55,408 21,710.9 72,262 26,375.2 308,679 17,672.5 386,036 21,129.6

2002/03 58,068 22,671.4 74,658 26,894.2 308,358 17,265.9 387,111 20,727.7

2003/04 60,665 23,574.3 77,906 27,616.1 312,816 17,187.7 394,673 20,799.9

2004/05 63,436 24,452.2 80,483 28,153.0 323,787 17,418.2 402,646 20,882.3

2005/06 66,030 24,873.9 84,055 28,920.8 332,351 17,609.7 410,801 21,040.1

2006/07 67,055 24,498.5 87,876 29,505.3 344,192 17,824.3 426,670 21,604.3

2007/08 65,713 23,065.3 87,810 28,551.5 346,955 17,681.3 432,665 21,767.0

2008/09 71,644 24,202.4 96,297 30,751.3 370,625 18,593.5 461,016 22,849.8

2009/10 74,056 24,405.5 100,371 31,487.8 383,104 18,787.1 478,423 23,287.7




Figure 7 shows age-specific hospital discharge rates for Māori and non-Māori in 2009/10. Hospitalisation rates were higher for Māori compared with non-Māori for all age groups except those aged 0–4 years and those aged 80 years and over. Specifically, the hospitalisation rate for Māori was: twice the rate for non-Māori in the 60–64-year age group more than 1.5 times the rate for non-Māori in the 15–19, 20–24, 40–44,

45–49,50–54, 55–59 and 65–69 year age groups.

Note that, due to the lower Māori population in the older age groups, rates for Māori should be interpreted with care.

Figure 7: Age-specific publicly funded hospital discharge rates by ethnicity, 2009/10

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0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Māori Non-Māori

Age-specific rate




Figure 8 shows that hospitalisation rates for Māori males were higher than rates for non-Māori males for all age groups except those aged 0–4 years and those aged 85 years and over in 2009/10. In particular, the hospitalisation rate for Māori males was: twice the rate for non-Māori males in the 60–64 year age group more than 1.5 times the rate for non-Māori males for those in the 25–29,

40–44,45–49, 50–54, 55–59 and 65–69-year age groups.


Figure 8: Age-specific publicly funded hospital discharge rates by ethnicity, males, 2009/10

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0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Māori males Non-Māori males

Age-specific rate




As shown in Figure 9, hospitalisation rates for Māori females were higher than non-Māori females for those aged 5–29 years and 35–79 years in 2009/10. Specifically, the hospitalisation rate for Māori females was: over twice the rate for non-Māori females in the 55–59 and 60–64 year

age groups more than 1.5 times the rate for non-Māori females for those in the 15–

19, 20–24, 40–44, 45–49, 50–54, 65–69 and 70–74 year age groups.


Figure 9: Age-specific publicly funded hospital discharge rates by ethnicity, females, 2009/10

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Age group (years)

Māori females Non-Māori females

Age-specific rate




DeprivationDeprivation has been associated with various health outcomes, and it is evident from the social inequalities literature that those who are most deprived generally experience poorer health (Benzeval et al 2001; White et al 2008). See the ‘Definitions’ section of this document for more information on the New Zealand Index of Deprivation.

Hospitalisation rates are presented in this publication by deprivation quintile according to the New Zealand Deprivation Index 2006 (Salmond and Crampton 2002).

Figure 10 shows that use of public and private hospitals was not evenly spread over the deprivation quintiles. As deprivation increased, publicly funded hospitalisation rates increased and privately funded hospitalisation rates decreased.

In 2009/10, the rate of publicly funded hospitalisations for the most deprived areas of New Zealand was more than twice the rate of the least deprived areas (31,049.3 compared with 15,045.0 hospitalisations per 100,000 people).

For privately funded hospitalisations, the rate for the most deprived areas was less than half the rate of the least deprived areas (796.7 compared with 1876.0 hospitalisations per 100,000 people).


Figure 10: Publicly and privately funded hospital discharge rates by deprivation quintile, 2009/10

0

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10,000

15,000

20,000

25,000

30,000

35,000

1 (least deprived) 2 3 4 5 (most deprived)

Deprivation quintile

Publicly funded hospital discharges Privately funded hospital discharges




Figure 11 shows rates of publicly funded hospital discharges by deprivation quintile and ethnicity. In 2009/10, hospitalisation rates for Māori were significantly11 higher than those for non-Māori at all levels of deprivation. The disparity between Māori and non-Māori hospitalisation rates was greatest in the most deprived areas (quintile 5) of New Zealand.

For both Māori and non-Māori, hospitalisation rates for the least deprived areas (quintile 1) were significantly lower than for the most deprived areas (quintile 5) in 2009/10.



Figure 11: Publicly funded hospital discharge rates by ethnicity and deprivation quintile, 2009/10

0

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25,000

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35,000



Māori Non-Māori



Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population; 95% confidence intervals.

District health board regionThis section presents publicly funded hospital discharge data by DHB region of residence. When interpreting regional differences in hospitalisation rates among DHBs, note that:

DHBs differ in their administrative practices, treatment practices and transfer practices

not all residents in a particular DHB will be treated in that DHB region

it is not possible to include regional comparisons of privately funded hospitalisations in this publication (see the ‘Data sources, data quality and timing issues’ section in the Introduction for further information).

Table 7 shows that the number of hospitalisations for males was lower than for females in 2009/10 in all DHB regions (excluding ‘overseas and undefined’). Males residing in Northland had the highest proportion (48.8%) and the highest rate of hospitalisations (28,544.5 per 100,000 males). Females residing in Capital & Coast had the highest proportion of hospitalisations (59.6%) and the second lowest rate (20,273.3 per 100,000 females).


Table 7: Publicly funded hospital discharges by DHB region, 2009/10

DHB region Number Rate Percent of discharges

Male Female Total Male Female Total Male Female Total

Northland 26,945 28,245 55,190 28,544.5 32,021.7 30,250.9 48.8 51.2 100.0

Waitemata 54,095 65,797 119,892 19,113.0 22,516.5 20,826.1 45.1 54.9 100.0

Auckland 39,900 53,334 93,234 18,424.2 22,092.6 20,286.8 42.8 57.2 100.0

Counties Manukau 51,064 67,875 118,939 20,575.1 26,744.5 23,759.3 42.9 57.1 100.0

Waikato 40,234 53,104 93,338 20,174.6 27,354.6 23,753.4 43.1 56.9 100.0

Lakes 12,178 14,875 27,053 21,663.8 27,451.1 24,612.3 45.0 55.0 100.0

Bay of Plenty 24,570 29,504 54,074 20,243.9 25,554.9 22,930.7 45.4 54.6 100.0

Tairawhiti 5641 6990 12,631 22,194.6 28,081.1 25,214.9 44.7 55.3 100.0

Hawke’s Bay 18,304 22,841 41,145 20,827.5 27,262.8 24,055.6 44.5 55.5 100.0

Taranaki 13,160 17,032 30,192 20,896.8 28,852.9 24,826.9 43.6 56.4 100.0

MidCentral 17,381 21,607 38,988 18,236.9 22,922.2 20,596.3 44.6 55.4 100.0

Whanganui 9080 11,220 20,300 24,956.4 32,976.7 28,901.2 44.7 55.3 100.0

Capital & Coast 22,296 32,905 55,201 15,230.6 20,273.3 17,848.1 40.4 59.6 100.0

Hutt Valley 13,867 17,740 31,607 17,913.9 22,884.6 20,394.4 43.9 56.1 100.0

Wairarapa 4563 5206 9769 19,246.4 23,774.4 21,493.3 46.7 53.3 100.0

Nelson Marlborough 13,542 15,683 29,225 16,293.5 20,832.9 18,503.7 46.3 53.7 100.0

West Coast 3784 4414 8198 18,577.0 24,269.7 21,449.5 46.2 53.8 100.0

Canterbury 48,130 64,043 112,173 17,244.8 23,227.7 20,195.9 42.9 57.1 100.0

South Canterbury 7000 8647 15,647 19,556.1 27,661.0 23,555.2 44.7 55.3 100.0

Otago 17,463 21,359 38,822 16,177.0 19,287.7 17,758.8 45.0 55.0 100.0

Southland 11,849 14,369 26,218 18,838.3 23,404.4 21,063.9 45.2 54.8 100.0

Overseas and undefined 2114 2004 4118 51.3 48.7 100.0

Total New Zealand 457,160 578,794 1,035,954 19,276.1 24,253.8 21,785.3 44.1 55.9 100.0


Note: Rates shown are age-standardised rates per 100,000 DHB population, standardised to the WHO world standard population.

Controlling for differences in age distribution (Figures 12 and 13), almost all DHB regions had hospitalisation rates that were likely to be significantly different from the New Zealand rate (10 were higher and nine were lower).

The DHB region with the highest rate of hospitalisations for the total population was Northland (30,250.9, n=55,190). Whanganui (28,901.2, n=20,300) and Tairawhiti (25,214.9, n=12,631) had the next highest rates. Only Wairarapa and West Coast DHB regions had rates that were not significantly different from the national rate. Otago (17,758.8, n=38,822) and Capital & Coast (17,848.1, n=55,201) had the lowest hospitalisation rates.


Figure 12: Publicly funded hospital discharge rates by DHB region, 2009/10

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New Zealand rate


Note: Rates shown are age-standardised rates per 100,000 DHB population, standardised to the WHO world standard population; 95% confidence intervals.

Figure 13 presents the same information as Figure 12 and shows that, compared to New Zealand as a whole:

more than half of DHB regions in the North Island had hospitalisation rates that were significantly higher (Northland, Whanganui, Tairawhiti, Taranaki, Lakes, Hawke’s Bay, Counties Manukau, Waikato and Bay of Plenty)

five DHB regions in the North Island had rates that were significantly lower (Waitemata, MidCentral, Hutt Valley, Auckland and Capital & Coast

one South Island DHB region had a hospitalisation rate that was significantly higher (South Canterbury)

four South Island DHB regions had rates that were significantly lower (Southland, Canterbury, Nelson Marlborough and Otago).


Figure 13: Publicly funded hospital discharge rates by DHB region, 2009/10




Table 8 presents publicly funded hospital discharge information for the Māori population by DHB region of residence in 2009/10. It shows that of all DHB regions, Nelson Marlborough had the highest proportion of hospitalisations for Māori females (61.9%). Northland DHB region had the highest proportion of hospitalisations for Māori males (48.0%).

Table 8: Publicly funded hospital discharges by DHB region, Māori population, 2009/10



Northland 11,252 12,200 23,452 49,839.5 49,334.5 49,366.4 48.0 52.0 100.0

Waitemata 5678 7267 12,945 23,004.2 29,318.3 26,289.7 43.9 56.1 100.0

Auckland 4040 5385 9425 24,040.6 29,386.8 26,814.8 42.9 57.1 100.0

Counties Manukau 8826 13,009 21,835 24,913.9 33,210.4 29,344.6 40.4 59.6 100.0

Waikato 8314 12,106 20,420 23,009.4 31,712.1 27,492.5 40.7 59.3 100.0

Lakes 4070 5492 9562 27,463.0 31,913.3 29,313.8 42.6 57.4 100.0

Bay of Plenty 5673 7980 13,653 23,912.0 31,425.8 27,677.8 41.6 58.4 100.0

Tairawhiti 2595 3605 6200 24,893.4 32,456.0 28,890.8 41.9 58.1 100.0

Hawke’s Bay 4459 6193 10,652 25,284.9 32,899.5 29,183.8 41.9 58.1 100.0

Taranaki 2045 3054 5099 23,064.1 36,160.0 29,448.4 40.1 59.9 100.0

MidCentral 2604 3525 6129 18,261.9 23,095.7 20,689.0 42.5 57.5 100.0

Whanganui 1882 2988 4870 24,831.1 37,974.1 31,801.5 38.6 61.4 100.0

Capital & Coast 2692 4224 6916 18,791.0 27,255.3 23,358.1 38.9 61.1 100.0

Hutt Valley 2301 3090 5391 20,507.2 26,612.6 23,506.5 42.7 57.3 100.0

Wairarapa 655 876 1531 22,481.9 29,556.9 26,181.8 42.8 57.2 100.0

Nelson Marlborough 801 1301 2102 12,190.3 21,353.1 16,742.5 38.1 61.9 100.0

West Coast 256 365 621 16,589.7 23,283.4 19,748.2 41.2 58.8 100.0

Canterbury 3282 4624 7906 16,229.6 24,543.6 20,371.8 41.5 58.5 100.0

South Canterbury 289 446 735 14,866.7 25,580.7 20,159.9 39.3 60.7 100.0

Otago 987 1133 2120 15,363.1 17,400.6 16,279.4 46.6 53.4 100.0

Southland 1229 1356 2585 18,411.1 22,057.8 20,349.0 47.5 52.5 100.0


Total New Zealand 74,056 100,371 174,427 24,604.8 31,459.8 28,147.0 42.5 57.5 100.0


Note: Rates shown are age-standardised rates per 100,000 DHB population for Māori, standardised to the WHO world standard population.


According to Figures 14 and 15, all DHB regions had hospitalisation rates for Māori that were significantly different from the national rate (seven were higher and 14 were lower).

Northland DHB region had the highest rate of hospitalisations for the Māori population (49,366.4, n=23,452). Whanganui had the next highest rate (31,801.5, n=4870). The DHB regions with the lowest rates were Otago (16,279.4, n=2120) and Nelson Marlborough (16,742.5, n=2102).

Figure 14: Publicly funded hospital discharge rates by DHB region, Māori population, 2009/10

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New Zealand rate


Note: Rates shown are age-standardised rates per 100,000 DHB population for Māori, standardised to the WHO world standard population; 95% confidence intervals.

Figure 15 presents the same information as Figure 14, and shows that compared to New Zealand as a whole:

seven of the 15 North Island DHB regions had hospitalisation rates for Māori that were significantly higher (Northland, Whanganui, Taranaki, Counties Manukau, Lakes, Hawke’s Bay and Tairawhiti)

all South Island DHB regions and eight North Island DHB regions had hospitalisation rates for Māori that were significantly lower.


Figure 15: Publicly funded hospital discharge rates by DHB region, Māori population, 2009/10




Selected diagnosesThis section presents information on publicly and privately funded hospital discharges by selected diagnoses. The diagnoses in this publication are classified according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification, 6th Edition (ICD-10-AM). Every discharge from hospital is classified according to a principal diagnosis and may have many additional diagnoses. A principal diagnosis is defined as the diagnosis to be chiefly responsible for causing the hospitalisation.

Publicly funded hospital dischargesTo provide context, Figure 16 shows the number of publicly funded hospitalisations by sex for the 10 most common ICD chapters for 2009/10. Note that publicly funded hospitalisations can occur in publicly or privately operated hospitals.

The ICD chapters with the highest number of publicly funded hospitalisations in 2009/10 were: factors influencing health status and contact with health services

(154,500) injury, poisoning and certain other consequences of external causes

(110,072) pregnancy, childbirth and the puerperium (102,075).


Figure 16: Publicly funded hospital discharges by sex and ICD chapter, 2009/10

0 40,000 80,000 120,000 160,000

N00–N99 XIV Diseases of the genitourinarysystem

M00–M99 XIII Diseases of themusculoskeletal system and connective

tissue

C00–D48 II Neoplasms

J00–J99 X Diseases of the respiratorysystem

I00–I99 IX Diseases of the circulatorysystem

K00–K93 XI Diseases of the digestivesystem

R00–R99 XVIII Symptoms, signs andabnormal clinical and laboratory findings

not elsewhere classified

O00–O99 XV Pregnancy, childbirth and thepuerperium

S00–T98 XIX Injury, poisoning and certainother consequences of external causes

Z00–Z99 XXI Factors influencing healthstatus and contact with health services

ICD chapter

Male Female

Number


Please note that ICD chapter Z00–Z99 (factors influencing health status and contact with health services) has been excluded from the following analyses of selected diagnoses.12

Table 9 shows age-standardised rates for selected diagnoses for publicly funded hospitalisations for the total population, Māori and non-Māori, by sex, in 2009/10.

After pregnancy and childbirth, the highest hospitalisation rates for the total population were for: cancer fractures chronic lower respiratory diseases

12 Categories Z00–Z99 (factors influencing health status and contact with health services) are provided for occasions when circumstances other than a disease, injury or external cause classifiable to categories A00–Y89 are recorded as ‘diagnoses’ or ‘problems’. As such, they have been excluded from analyses of selected diagnoses in this section of the publication. For example, categories Z40–Z54 are intended to indicate a reason for care. They are used for patients who have already been treated for a disease or injury, but who are receiving follow-up care or care to consolidate the treatment, to ensure that the condition has not recurred or to prevent recurrence. Infants are also included (Z38: Liveborn infants according to place of birth).


other forms of heart disease.

The highest hospitalisation rates for Māori (after pregnancy and childbirth) were for: chronic lower respiratory diseases cancer fractures other forms of heart disease.

Table 9: Age-standardised publicly funded hospital discharge rates for selected diagnoses by sex and ethnicity, 2009/10

ICD code Diagnoses Total population Māori population Non-Māori population


C00–C96, D45–D47

Total cancer 942.6 738.1 830.2 831.7 860.6 847.6 941.0 724.0 821.9

C16 Stomach cancer 17.9 10.1 13.7 35.3 35.5 35.3 16.2 7.1 11.3

C18–C21 Colorectal cancer* 71.4 61.4 66.1 57.7 49.2 53.4 72.0 61.8 66.7

C33–C34 Lung cancer† 52.7 42.3 47.0 115.8 121.2 118.3 47.3 35.4 40.8

C43 Melanoma of the skin 26.8 20.9 23.6 5.9 3.3 4.5 28.6 22.7 25.4

C50 Breast cancer 0.7 94.4 49.4 0.4 144.3 76.8 0.7 88.9 46.4

C53 Cervical cancer … 14.4 7.5 … 28.0 15.0 … 12.6 6.5

C61 Prostate cancer 65.9 … 30.6 71.6 … 32.8 65.3 … 30.3

E10–E14 Diabetes mellitus 232.1 200.2 215.0 537.5 474.9 503.0 206.1 173.4 188.7

F00–F09 Organic, including symptomatic, mental disorders

39.6 32.9 36.2 33.0 36.9 35.8 39.3 32.5 35.8

I05–I09 Chronic rheumatic heart disease

10.2 13.3 11.8 25.2 42.2 34.1 8.3 9.6 8.9

I10–I15 Hypertensive diseases 17.0 22.2 19.9 29.8 40.2 35.4 15.1 19.8 17.8

I20–I25 Ischaemic heart diseases

528.2 251.6 383.9 587.0 435.9 508.5 517.3 233.0 369.3

I30–I52 Other forms of heart disease‡

476.2 322.6 395.8 830.1 601.5 711.2 439.7 297.5 365.3

I60–I69 Cerebrovascular diseases

147.7 125.2 136.2 177.1 206.7 195.0 143.0 118.0 130.1

J09–J18 Pneumonia and influenza

350.6 303.6 324.3 556.0 497.0 521.9 325.0 275.7 297.6

J40–J47 Chronic lower respiratory diseases

461.7 455.7 457.6 901.6 1083.0 998.7 396.8 373.6 383.6

J40–J44 COPD§ 199.5 180.4 187.3 462.1 559.6 512.2 177.9 147.2 159.8

K80 Cholelithiasis (gallstones)

88.9 226.2 158.4 128.1 354.6 245.9 83.5 204.0 144.2

N17–N19 Renal failure 51.8 36.7 43.3 77.2 75.6 76.7 48.9 32.6 39.8

O00–O99 Pregnancy, childbirth and the puerperium

… 5312.6 2690.7 … 6868.8 3541.6 … 4938.6 2496.3

Q00–Q99 Congenital anomalies 254.1 178.8 217.4 217.0 153.3 186.0 268.5 187.6 229.0

All fracturesф 932.5 559.3 751.1 1032.8 491.8 758.9 908.6 561.0 740.7

All diagnoses 19,295.6 24,259.3 21,794.8 24,405.5 31,487.8 28,072.1 18,787.1 23,287.7 21,043.4


Source: National Minimum DatasetNote: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.* Includes cancer of the colon, rectosigmoid junction, rectum, anus and anal canal.† Includes cancer of the trachea, bronchus and lung.‡ Includes pericardial diseases, valve disorders, myocarditis, cardiomyopathy, conduction disorders, cardiac arrest and

heart failure, but excludes chronic rheumatic heart disease.§ Chronic obstructive pulmonary disease.ф Includes ICD codes S02 (fracture of skull and facial bones), S12 (fracture of neck), S22 (fracture of rib(s), sternum and

thoracic spine), S32 (fracture of lumbar spine and pelvis), S42 (fracture of shoulder and upper arm), S52 (fracture of forearm), S62 (fracture at wrist and hand level), S72 (fracture of femur), S82 (fracture of lower leg, including ankle), S92 (fracture of foot, except ankle), T02 (fractures involving multiple body regions), T08 (fracture of spine, level unspecified) and T12 (fracture of lower limb, level unspecified).

... = not applicable.

Sex-based differences in publicly funded hospitalisationsOverall, females had a higher age-standardised hospitalisation rate compared with males. However, hospitalisations for pregnancy and childbirth were a large component (17.6%) of female hospitalisations. For most other selected diagnoses, male hospitalisation rates were higher than female rates.

Table 9 shows that in 2009/10 females had: more than 2.5 times the male hospitalisation rate for gallstones higher hospitalisation rates for hypertensive diseases and chronic

rheumatic heart disease.

Conversely, males had:

over twice the female hospitalisation rate for ischaemic heart diseases

more than 1.5 times the female hospitalisation rate for stomach cancer and fractures

almost 1.5 times the female hospitalisation rate for other forms of heart disease, congenital anomalies and renal failure

rates approximately 25% higher for total cancer, melanoma of the skin and lung cancer, compared with females.

Ethnicity-based differences in publicly funded hospitalisationsIn 2009/10, Māori had a total hospitalisation rate that was 1.3 times the non-Māori rate (age-standardised rate that was 28,072.1 for Māori and 21,043.4 for non-Māori).

Māori had higher hospitalisation rates than non-Māori for most diagnoses shown in Table 9. For example, in 2009/10 Māori had:

almost four times the non-Māori hospitalisation rate for chronic rheumatic heart disease

more than three times the non-Māori hospitalisation rate for chronic obstructive pulmonary disease (COPD) and stomach cancer


almost three times the hospitalisation rate for lung cancer compared with non-Māori

more than 2.5 times the non-Māori hospitalisation rate for diabetes and chronic lower respiratory diseases

over twice the hospitalisation rate for cervical cancer compared with non-Māori

approximately twice the non-Māori hospitalisation rate for hypertensive diseases, other forms of heart disease and renal failure

more than 1.5 times the non-Māori hospitalisation rate for pneumonia and influenza, gallstones and breast cancer

1.5 times the hospitalisation rate for cerebrovascular diseases compared with non-Māori.

In 2009/10, non-Māori had:

over 5.5 times the Māori hospitalisation rate for melanoma of the skin

approximately 25% higher rates for colorectal cancer and congenital anomalies compared with Māori

similar rates to Māori for organic (including symptomatic) mental disorders, fractures and total cancer.

Of publicly funded hospitalisations for cancer in 2009/10, lung cancer was the leading diagnosis for Māori while colorectal cancer was the leading diagnosis for non-Māori (controlling for differences in age distribution).

Privately funded hospital dischargesTo provide context, Figure 17 shows the number of privately funded hospitalisations by sex for the 10 most common ICD chapters for 2009/10. Note that privately funded hospitalisations can occur in public or private hospitals.

The ICD chapters with the highest number of privately funded hospitalisations in 2009/10 were: diseases of the musculoskeletal system (12,873) factors influencing health status and contact with health services

(11,690) diseases of the digestive system (8886).

Just 2.3% of privately funded hospitalisations for females were for pregnancy and childbirth in 2009/10 (compared with 17.6% of publicly funded hospitalisations for females).


Figure 17: Privately funded hospital discharges by sex and ICD chapter, 2009/10

0 2,000 4,000 6,000 8,000 10,000 12,000 14,000

L00–L99 XII Diseases of the skin andsubcutaneous tissue

H60–H95 VIII Diseases of the ear andmastoid process

I00–I99 IX Diseases of the circulatorysystem

C00–D48 II Neoplasms

J00–J99 X Diseases of the respiratorysystem

H00–H59 VII Diseases of the eye andadnexa

N00–N99 XIV Diseases of the genitourinarysystem

K00–K93 XI Diseases of the digestivesystem

Z00–Z99 XXI Factors influencing healthstatus and contact with health services

M00–M99 XIII Diseases of themusculoskeletal system and connective

tissue

ICD chapter

Male Female

Number


Table 10 shows age-standardised rates for selected diagnoses for privately funded hospitalisations for the total population13 in 2009/10.

The highest hospitalisation rates for the total population in 2009/10 were for: cancer, particularly prostate cancer pregnancy and childbirth congenital anomalies.

13 Ethnicity data for privately funded hospitalisations are not shown due to the high number of privately funded hospital discharges that have no ethnicity information recorded.


Table 10: Age-standardised privately funded hospital discharge rates for selected diagnoses by sex, 2009/10

ICD code Diagnoses Total population

Male Female Total

C00–C96, D45–D47 Total cancer 53.5 26.4 39.4

C16 Stomach cancer 0.3 0.2 0.2

C18–C21 Colorectal cancer* 2.3 2.0 2.1

C33–C34 Lung cancer† 1.0 0.5 0.7

C43 Melanoma of the skin 1.2 0.6 0.9

C50 Breast cancer 0.0 13.8 7.1

C53 Cervical cancer … 0.2 0.1

C61 Prostate cancer 37.4 … 18.1

E10–E14 Diabetes mellitus 2.8 3.5 3.2

F00–F09 Organic, including symptomatic, mental disorders 2.1 2.2 2.2

I05–I09 Chronic rheumatic heart disease 0.7 0.6 0.7

I10–I15 Hypertensive diseases 0.3 0.7 0.5

I20–I25 Ischaemic heart diseases 14.3 5.3 9.5

I30–I52 Other forms of heart disease‡ 9.3 4.4 6.7

I60–I69 Cerebrovascular diseases 3.6 2.2 2.8

J09–J18 Pneumonia and influenza 3.9 2.5 3.2

J40–J47 Chronic lower respiratory diseases 2.3 2.1 2.2

J40–J44 COPD§ 1.1 1.2 1.1

K80 Cholelithiasis (gallstones) 1.6 4.7 3.2

N17–N19 Renal failure 0.3 0.3 0.3

O00–O99 Pregnancy, childbirth and the puerperium … 45.5 23.0

Q00–Q99 Congenital anomalies 10.3 12.2 11.3

All fracturesф 3.0 1.9 2.5

All diagnoses 1318.9 1493.1 1407.7


Note: Rates shown are age-standardised rates per 100,000 people, standardised to the WHO world standard population.* Includes cancer of the colon, rectosigmoid junction, rectum, anus and anal canal.† Includes cancer of the trachea, bronchus and lung.‡ Includes pericardial diseases, valve disorders, myocarditis, cardiomyopathy, conduction disorders,

cardiac arrest and heart failure, but excludes chronic rheumatic heart disease.§ Chronic obstructive pulmonary disease.ф Includes ICD codes S02 (fracture of skull and facial bones), S12 (fracture of neck), S22 (fracture of

rib(s), sternum and thoracic spine), S32 (fracture of lumbar spine and pelvis), S42 (fracture of shoulder and upper arm), S52 (fracture of forearm), S62 (fracture at wrist and hand level), S72 (fracture of femur), S82 (fracture of lower leg, including ankle), S92 (fracture of foot, except ankle), T02 (fractures involving multiple body regions), T08 (fracture of spine, level unspecified) and T12 (fracture of lower limb, level unspecified).

... = not applicable.


Sex-based differences in privately funded hospitalisationsOverall, females had a higher privately funded hospitalisation rate compared with males (age-standardised rate that was 1493.1 for females and 1318.9 for males).

Table 10 shows that in 2009/10 females had: almost three times the male hospitalisation rate for gallstones more than twice the male hospitalisation rate for hypertensive diseases a higher hospitalisation rate for diabetes and congenital anomalies.

In 2009/10, males had:

over 2.5 times the female hospitalisation rate for ischaemic heart diseases

over twice the female hospitalisation rate for other forms of heart disease, total cancer and lung cancer

almost twice the female hospitalisation rate for melanoma of the skin

over 1.5 times the female hospitalisation rate for stomach cancer, fractures, cerebrovascular disease, and pneumonia and influenza

higher hospitalisation rates for colorectal cancer and chronic lower respiratory diseases.


Length of stay and bed daysThis section focuses on the average number of days (length of stay) and the total number of days (bed days) spent in public and private hospitals. It presents data for inpatients, and excludes day cases (patients hospitalised for zero days and discharged routinely). See the ‘Definitions’ section for a more detailed explanation of length of stay. It should be noted that average length of stay data is skewed by long-stay geriatric events. For example, one patient had been in hospital for almost 19 years in 2009/10.

For publicly funded hospitalisations, the average length of stay increased by 1.4 days and the total number of bed days increased by nearly 2 million (or 58.3%) from 1995/96 to 2009/10 (Table 11).

Non-Māori spent longer, on average, in publicly funded hospitals compared with Māori. In 1995/96 non-Māori spent 2.1 days longer in hospital compared with Māori. In 2009/10 this disparity increased to 3.8 days and was greatest between females. Non-Māori females spent 4.9 days longer in hospital, on average, than Māori females in this year.

While the number of bed days for Māori increased over time, the proportion of bed days for Māori fell slightly (from 10.3% of total bed days in 1995/96 to 10.0% in 2009/10).

Table 11: Average length of stay and total bed days by sex and ethnicity, publicly funded hospital discharges, 1995/96 and 2009/10

Population 1995/96 2009/10

Average length of stay Average length of stay

Male Female Total Male Female Total

Māori 5.5 4.2 4.7 5.7 4.1 4.8

Non-Māori 6.9 6.8 6.8 8.0 9.0 8.5

Total 6.7 6.4 6.5 7.6 8.2 7.9

Bed days Bed days


Māori 157,103 183,584 340,687 261,018 262,476 523,494

Non-Māori 1,276,056 1,690,242 2,966,298 1,914,325 2,797,458 4,711,783

Total 1,433,159 1,873,826 3,306,985 2,175,343 3,059,934 5,235,277

Percent of total bed days Percent of total bed days


Māori 11.0 9.8 10.3 12.0 8.6 10.0

Non-Māori 89.0 90.2 89.7 88.0 91.4 90.0

Total 100.0 100.0 100.0 100.0 100.0 100.0



Table 12 shows that for privately funded hospitalisations, the average length of stay increased by 4.2 days from 2004/05 to 2009/10. The total number of bed days increased by over 80,000 (or 20.9%) over the same time period. Females spent longer, on average, in privately funded hospitals compared with males. In 2004/05 females spent almost six days longer in hospital compared with males. In 2009/10 this disparity decreased to just under five days.

Table 12: Average length of stay and total bed days by sex, privately funded hospital discharges, 2004/05 and 2009/10

2004/05 2009/10



Total population 7.3 13.1 10.5 12.0 16.9 14.8

Bed days Bed days


Total population 115,479 267,040 382,519 165,131 297,441 462,572


Note: Ethnicity data for privately funded hospital discharges are not included due to the high number of hospitalisations that have no ethnicity information recorded.

Table 13 shows the average length of stay and the total number of bed days for publicly funded hospitalisations by DHB region of residence in 2009/10. Of all DHB regions: South Canterbury had the longest average length of stay (11.8 days) Tairawhiti had the shortest average length of stay (4.9 days) Canterbury had the highest number of bed days (733,254) Tairawhiti had the lowest number of bed days (40,946).

Compared to New Zealand as a whole: all DHB regions in the South Island had a longer average length of stay the majority of DHB regions in the North Island had a shorter average

length of stay (Wairarapa, Waikato, Lakes, MidCentral, Waitemata, Whanganui, Hawke’s Bay, Taranaki, Northland, Counties Manukau, and Tairawhiti).


Table 13: Average length of stay and total bed days by DHB region, total population, publicly funded hospital discharges, 2009/10

DHB region Average length of stay Total bed days

Male Female Total Male Female TotalNorthland 5.4 5.8 5.6 68,613 83,750 152,363

Waitemata 6.4 7.2 6.9 218,097 316,758 534,855

Auckland 9.4 8.7 9.0 250,176 320,231 570,407

Counties Manukau 5.6 5.1 5.3 184,566 234,047 418,613

Waikato 6.8 7.8 7.4 162,629 249,498 412,127

Lakes 6.1 8.2 7.2 49,692 79,385 129,077

Bay of Plenty 9.4 9.9 9.7 147,680 182,464 330,144

Tairawhiti 5.1 4.8 4.9 18,789 22,157 40,946

Hawke’s Bay 6.0 6.8 6.5 70,266 100,081 170,347

Taranaki 6.1 6.3 6.3 50,673 68,583 119,256

MidCentral 6.4 7.5 7.0 68,679 101,250 169,929

Whanganui 5.6 7.6 6.7 29,689 50,841 80,530

Capital & Coast 9.3 10.7 10.1 132,828 226,269 359,097

Hutt Valley 8.4 10.9 9.8 69,919 118,034 187,953

Wairarapa 7.2 8.0 7.6 22,318 28,709 51,027

Nelson Marlborough 7.9 9.1 8.5 66,689 89,894 156,583

West Coast 8.5 9.1 8.8 21,590 27,665 49,255

Canterbury 9.8 9.8 9.8 307,486 425,768 733,254

South Canterbury 11.1 12.4 11.8 44,089 65,876 109,965

Otago 10.4 11.2 10.8 121,508 166,562 288,070

Southland 8.3 10.2 9.4 61,865 95,739 157,604

Overseas and undefined 5.0 4.5 4.8 7502 6373 13,875

Total New Zealand 7.6 8.2 7.9 2,175,343 3,059,934 5,235,277


Table 14 shows the average length of stay and total number of bed days for publicly funded hospitalisations for Māori in 2009/10. Of all DHB regions:

Otago had the longest average length of stay (6.7 days)

West Coast and Wairarapa had the shortest average length of stay (3.8 days).

Counties Manukau and Waikato had the highest number of bed days for Māori (62,536 and 62,482)

West Coast had the lowest number of bed days (1,734).


Table 14: Average length of stay and total bed days by DHB region, Māori population, publicly funded hospital discharges, 2009/10



Northland 4.8 4.1 4.4 21,447 24,216 45,663

Waitemata 5.2 3.7 4.3 19,149 17,869 37,018

Auckland 8.7 5.0 6.6 22,683 17,894 40,577


Waikato 5.9 4.2 4.9 30,697 31,785 62,482

Lakes 5.1 4.5 4.7 14,310 16,288 30,598

Bay of Plenty 5.8 4.8 5.3 23,085 24,771 47,856

Tairawhiti 4.4 3.9 4.1 8140 9911 18,051

Hawke’s Bay 4.6 3.7 4.1 13,858 15,304 29,162

Taranaki 5.2 3.8 4.3 7020 7524 14,544

MidCentral 4.5 4.0 4.2 7404 8759 16,163

Whanganui 5.2 3.8 4.3 5780 7283 13,063

Capital & Coast 7.9 5.4 6.4 13,558 14,210 27,768

Hutt Valley 7.9 3.9 5.6 11,308 7323 18,631

Wairarapa 3.8 3.8 3.8 1747 2274 4021

Nelson Marlborough 4.5 4.1 4.2 2265 3275 5540

West Coast 4.6 3.3 3.8 806 928 1734

Canterbury 7.7 4.1 5.6 15,932 11,790 27,722

South Canterbury 4.8 5.8 5.4 833 1800 2633

Otago 7.7 5.8 6.7 5162 4326 9488

Southland 5.1 3.2 4.1 4046 2798 6844

Overseas and undefined 6.8 6.7 6.8 658 742 1400

Total New Zealand 5.7 4.1 4.8 261,018 262,476 523,494


Compared to New Zealand as a whole:

three DHB regions in the South Island had a longer average length of stay for Māori (Otago, Canterbury and South Canterbury)

five DHB regions in the North Island had a longer average length of stay for Māori (Auckland, Capital & Coast, Hutt Valley, Bay of Plenty and Waikato).


Inpatients and day casesThis section presents hospital discharges by patient type: inpatients and day cases.

For this publication a day case is defined as a patient hospitalised for zero days and discharged routinely. An inpatient is a patient who does not fit the day case criteria. See the ‘Definitions’ section for more detailed explanations of inpatients and day cases.

In 2009/10, day cases made up 36.2% (375,276) of publicly funded hospitalisations, with the remaining 63.8% being inpatients (Table 15). The proportion of day cases was higher for privately funded hospitalisations. Day cases made up over half of all privately funded hospitalisations in each year from 2004/05 to 2009/10.

The number of publicly funded day case hospitalisations in 2009/10 was more than 2.5 times that in 1995/96. Furthermore, the proportion of day cases increased from one in five publicly funded hospitalisations (21.9%) in 1995/96 to over one-third (36.2%) in 2009/10. Some of this increase is due to some DHBs reporting short-stay emergency department events that were previously considered outpatient events. The proportion of privately funded day case discharges remained relatively stable from 2004/05 to 2009/10.

Table 15: Hospital discharges by patient type, 1995/96–2009/10

Year Publicly funded hospital discharges Privately funded hospital discharges

Inpatient Day case % day case Inpatient Day case % day case

1995/96 507,258 142,233 21.9

1996/97 499,595 152,336 23.4

1997/98 507,812 173,210 25.4

1998/99 514,760 189,435 26.9

1999/00 536,778 207,644 27.9

2000/01 563,894 236,079 29.5

2001/02 572,232 250,154 30.4

2002/03 570,965 257,230 31.1

2003/04 580,742 265,318 31.4

2004/05 583,786 286,566 32.9 36,267 50,580 58.2

2005/06 592,473 300,764 33.7 34,258 49,353 59.0

2006/07 607,082 318,711 34.4 33,555 48,248 59.0

2007/08 618,570 314,573 33.7 30,453 41,709 57.8

2008/09 644,826 354,756 35.5 34,066 42,717 55.6

2009/10 660,678 375,276 36.2 31,357 39,879 56.0



Figure 18 shows age-specific rates for publicly funded inpatient and day case hospitalisations in 2009/10. Those aged 85 years and over had the highest inpatient rate (68,256.5 per 100,000 people) while those aged 80–84 had the highest day case rate (22,651.5 per 100,000).

The rate of inpatient hospitalisations was greater than day case hospitalisations for all age groups except for those aged 5–9 years. As would be expected, the inpatient rate was: more than 3.5 times the day case rate for those aged 85 and over almost three times the day case rate for those aged 0–4 years more than twice the day case rate for those aged 80–84 years approximately twice the day case rate for those aged 30–34 years.

Figure 18: Age-specific publicly funded hospital discharge rates by patient type, 2009/10

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Inpatient Day case

Age-specific rate




Figure 19 shows privately funded hospitalisation rates by five-year age group and patient type for 2009/10. Those aged 85 years and over had the highest inpatient rate (1987.4 per 100,000 people) while those aged 80–84 and 75–79 had the highest day case rates (2061.7 and 2047.0 respectively).

The rate of day case hospitalisations was greater than inpatient hospitalisations for all age groups except those aged 30–34 and 85 years and over. Furthermore, the day case rate was: over four times the inpatient rate for those aged 5–9 years more than three times the inpatient rate for those aged 0–4 years more than twice the inpatient rate for those aged 10–14 years 1.5 times the inpatient rate for those aged 75–79 and 80–84 years.

Figure 19: Age-specific privately funded hospital discharge rates by patient type, 2009/10

0

500

1000

1500

2000

2500

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Inpatient Day case

Age-specific rate




Figure 20 shows publicly funded inpatient hospitalisation rates by five-year age group and ethnicity for 2009/10. The highest inpatient rates occurred in Māori aged 80–84 and in non-Māori aged 85 years and over. Overall, Māori had higher inpatient rates compared with non-Māori. The inpatient rate was greater for Māori for most age groups except those aged 0–4 and 85 years and over. In particular, the Māori inpatient rate was: almost twice the non-Māori rate for those aged 20–24 and 45–69 years around 1.5 times the non-Māori rate for those aged 15–19, 25–29, 40–44

and 70–74 years.


Figure 20: Age-specific publicly funded hospital discharge rates by ethnicity, inpatients, 2007/08

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Māori inpatients Non-Māori inpatients

Age-specific rate




Figure 21 shows publicly funded day case hospitalisation rates by five-year age group and ethnicity for 2009/10. Those aged 75–79 years had the highest day case rate for both Māori and non-Māori. Overall, Māori had higher day case rates compared with non-Māori. The day case rate was greater for Māori for most age groups except those aged 0–4, 10–14 and 80 years and over.

The greatest disparities between day case rates occurred in those aged 55–69 years, where Māori rates were approximately double the non-Māori rates for each five year age group.


Figure 21: Age-specific publicly funded hospital discharge rates by ethnicity, day cases, 2009/10

0

5,000

10,000

15,000

20,000

25,000

30,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Māori day cases Non-Māori day cases

Age-specific rate




Figure 22 shows publicly funded hospitalisation rates by deprivation quintile and patient type for 2009/10. Controlling for differences in age distribution, hospitalisation rates for inpatients and day cases increased as deprivation increased.

For the most deprived areas (quintile 5), both inpatient and day case rates were more than twice the rates for the least deprived areas (quintile 1). For each deprivation quintile, inpatient rates were approximately 75% higher than day case rates.

Figure 22: Publicly funded hospital discharges by deprivation quintile and patient type, 2009/10

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000



Inpatients Day cases





Figure 23 shows privately funded hospitalisation rates by deprivation quintile and patient type for 2009/10. Controlling for differences in age distribution, hospitalisation rates for inpatients and day cases decreased as deprivation increased (the opposite trend to that shown in Figure 22 for publicly funded hospitalisations).

At all levels of deprivation, day case rates were higher than inpatient rates. The greatest disparity between privately funded inpatient and day case hospitalisations occurred in the least deprived areas of New Zealand (where the rate for day cases was more than 1.5 times the rate for inpatients).

Figure 23: Privately funded hospital discharges by deprivation quintile and patient type, 2009/10

0

200

400

600

800

1000

1200



Inpatients Day cases




Hospital proceduresThis chapter presents statistics on hospital procedures performed in publicly and privately funded New Zealand hospitals. Note that information is presented according to the number of procedures performed, rather than the number of patients. Some patients will experience more than one procedure during their hospitalisation. Also, patients may be hospitalised more than once in a given year.

OverviewMore than 1.5 million procedures were performed in New Zealand hospitals in 2009/10. Publicly funded procedures made up the majority of all hospital procedures. In 2009/10, 90.3% of hospital procedures were publicly funded.

Over the past six years, the number of publicly funded hospital procedures increased by 21.6%, while the number of reported privately funded procedures decreased by 9.6%.

The number of publicly funded hospital procedures relative to the population was 28,617.5 per 100,000 in 2009/10. In the same year, there were 2926.8 privately funded procedures per 100,000 people (Table 16).

Compared with 2008/09, there were 1449 more publicly funded procedures and 336 fewer privately funded procedures per 100,000 people in 2009/10.

SexEach year more procedures are performed on females than males. There were 80 male procedures for every 100 female procedures in 2009/10. In this year, females accounted for 55.6% of all publicly funded and privately funded hospital procedures. Almost one in five procedures performed on females in 2009/10 was an obstetric (or maternity-related) procedure. Refer to the ‘Selected procedures’ section of this publication for further information.

Table 16 presents the number of hospital procedures and age-standardised rates by sex from 1 July 1995 to 30 June 2010. In 2009/10, a total of 844,585 publicly and privately funded procedures were performed on females and 675,381 were performed on males. Accounting for changes in the New Zealand population, the rate of publicly funded procedures


increased by 92.4% from 1995/96 to 2009/10. The rate of reported privately funded procedures fell by 17.7% from 2004/05 to 2009/10.

Table 16: Hospital procedures and age-standardised rates by sex, 1995/96–2009/10

Publicly funded hospital procedures



1995/96 233,342 12,091.1 354,799 17,692.3 588,141 14,875.5

1996/97 274,405 13,978.0 405,129 19,827.5 679,534 16,888.6

1997/98 313,918 15,783.1 451,563 21,831.1 765,481 18,792.1

1998/99 327,363 16,311.2 454,408 21,811.7 781,771 19,062.4

1999/00 307,313 15,195.8 436,745 21,077.3 744,058 18,159.1

2000/01 324,973 15,886.6 451,912 21,659.6 776,885 18,801.8

2001/02 434,540 20,930.3 572,269 26,826.5 1,006,809 23,905.3

2002/03 452,637 21,295.8 592,314 27,165.3 1,044,951 24,260.7

2003/04 468,088 21,634.8 609,969 27,533.2 1,078,057 24,622.3

2004/05 500,009 22,850.0 629,480 28,259.3 1,129,489 25,602.4

2005/06 526,669 23,743.7 652,768 28,991.3 1,179,437 26,424.9

2006/07 545,952 24,151.6 680,770 30,006.5 1,226,722 27,133.9

2007/08 553,532 24,059.1 695,723 30,394.9 1,249,255 27,276.2

2008/09 563,583 23,868.8 710,178 30,383.4 1,273,761 27,168.5

2009/10 609,712 25,218.2 763,560 31,937.8 1,373,272 28,617.5

Privately funded hospital procedures



2004/05 72,278 3245.0 90,053 3857.9 162,331 3555.6

2005/06 77,517 3401.7 98,278 4117.2 175,795 3766.2

2006/07 75,510 3246.7 94,918 3923.6 170,428 3592.0

2007/08 64,868 2745.2 83,569 3436.4 148,437 3097.6

2008/09 73,284 3055.5 85,989 3462.1 159,273 3263.4

2009/10 65,669 2664.0 81,025 3176.7 146,694 2926.8



Note 2: The increase in the rate of publicly funded procedures from 2000/01 to 2001/02 was largely due to coding changes that required anaesthesia to be coded separately.


Figure 24 shows females had a consistently higher rate of publicly funded and privately funded procedures than males. From 1999/00 to 2009/10, the rate of publicly funded procedures increased by 51.5% for females and 66.0% for males. The increase in the rate of publicly funded procedures from 2000/01 to 2001/02 was largely due to coding changes that required anaesthesia to be coded separately.

For privately funded procedures, the rate for females and males decreased by 17.7% and 17.9% respectively, from 2004/05 to 2009/10.

Figure 24: Age-standardised hospital procedure rates by sex, 1999/00–2009/10

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10

Year

Male publicly funded hospital procedures

Female publicly funded hospital procedures

Male privately funded hospital procedures

Female privately funded hospital procedures





AgeTable 17 shows that the age group with the highest number of publicly funded hospital procedures in 2009/10 was 0–4 year olds (94,160 or 6.9% of total procedures), followed by 65–69 year-olds (91,817 or 6.7% of total procedures).


Those aged 80–84 years had the highest rate of publicly funded procedures in 2009/10. Within this age group, more than 107,000 procedures were performed per 100,000 males and more than 80,000 procedures were performed per 100,000 females.

Note that these rates were calculated according to the number of procedures performed, rather than the number of patients. Multiple procedures can be reported for a single theatre visit. Also, some patients may be hospitalised more than once in a given year.

Table 17: Publicly funded hospital procedures by five-year age group and sex, 2009/10

Age group (years)

Male Female Total


0–4 54,676 34,168.2 39,484 26,005.4 94,160 30,194.0

5–9 32,412 22,064.0 25,477 18,208.3 57,889 20,183.0

10–14 20,014 13,203.6 13,560 9403.0 33,574 11,351.0

15–19 24,285 14,672.8 34,257 21,836.4 58,542 18,158.8

20–24 23,421 14,513.0 54,906 35,690.3 78,327 24,848.4

25–29 18,719 13,073.8 64,330 44,295.3 83,049 28,795.5

30–34 17,539 13,561.4 73,929 52,810.2 91,468 33,961.3

35–39 23,212 16,232.2 62,810 39,680.3 86,022 28,551.2

40–44 27,705 18,552.9 40,840 25,147.8 68,545 21,988.6

45–49 33,982 21,763.8 38,775 23,284.1 72,757 22,548.4

50–54 37,711 26,437.9 37,311 25,066.2 75,022 25,738.3

55–59 40,885 33,124.0 37,161 29,052.5 78,046 31,052.0

60–64 48,678 43,043.6 42,845 36,550.9 91,523 39,739.0

65–69 49,511 57,577.6 42,306 46,886.8 91,817 52,103.6

70–74 48,205 73,606.7 42,371 59,293.3 90,576 66,138.0

75–79 46,782 95,707.9 40,234 71,463.6 87,016 82,730.6

80–84 37,321 107,244.3 36,741 80,028.3 74,062 91,763.1

85+ 24,654 103,111.7 36,223 78,438.7 60,877 86,855.5

All ages 609,712 28,430.1 763,560 34,345.1 1,373,272 31,440.8


Note 1: The rates shown are age-specific rates per 100,000 people in each age group. The ‘all ages’ rate is the crude rate.

Note 2: The rate shown is based on number of procedures. Some patients may experience more than one procedure during their hospitalisation. Patients may also be hospitalised more than once in a given year.


Table 18 shows that over half of all privately funded procedures (55.0%) were performed on those aged 40–69 years in 2009/10. This age-related trend has occurred each year since 2004/05.

Those aged 65–69 years had the highest rate of privately funded procedures in 2009/10. Within this age group, more than 7600 procedures were performed per 100,000 males and over 6700 procedures were performed per 100,000 females.

Table 18: Privately funded hospital procedures by five-year age group and sex, 2009/10

Age group (years)

Male Female Total


0–4 4032 2519.7 2764 1820.5 6796 2179.3

5–9 2348 1598.4 1650 1179.2 3998 1393.9

10–14 1202 793.0 1139 789.8 2341 791.5

15–19 2089 1262.2 2670 1701.9 4759 1476.2

20–24 2248 1393.0 3199 2079.4 5447 1728.0

25–29 1745 1218.7 2833 1950.7 4578 1587.3

30–34 1983 1533.3 3914 2795.9 5897 2189.5

35–39 2798 1956.6 5871 3709.0 8669 2877.3

40–44 3656 2448.3 6961 4286.3 10,617 3405.8

45–49 4835 3096.6 8245 4951.1 13,080 4053.7

50–54 5847 4099.1 8129 5461.2 13,976 4794.8

55–59 6703 5430.6 7856 6141.8 14,559 5792.6

60–64 8026 7097.0 7864 6708.8 15,890 6899.4

65–69 6555 7623.0 6054 6709.5 12,609 7155.3

70–74 4401 6720.1 4304 6022.9 8705 6356.3

75–79 3494 7148.1 3270 5808.2 6764 6430.9

80–84 2295 6594.8 2548 5550.0 4843 6000.5

85+ 1412 5905.5 1754 3798.2 3166 4517.0

All ages 65,669 3062.1 81,025 3644.5 146,694 3358.5




Figure 25 shows publicly funded hospital procedure rates by five-year age group and sex for 2009/10. The trend is similar to that for publicly funded hospitalisation rates (refer to Figure 4).

Females had higher procedure rates than males over the child-bearing years (between 15 and 49 years). For males, the rate of procedures generally increased with age, from 10 years.

For both males and females, the rate of hospitalisations peaked in the 80–84 year age group. For females aged 25–34 years, the procedure rate was approximately 3.5 times the rate for males. Obstetric procedures made up more than half (53.5%) of all publicly funded procedures for females in this age range.

Figure 25: Age-specific publicly funded hospital procedure rates by sex, 2009/10

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

100,000

110,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Male Female

Age-specific rate


Note 1: Rates shown are age-specific rates per 100,000 people in each age group.

Note 2: Rates shown are based on number of procedures. Some patients may experience more than one procedure during their hospitalisation. Patients may also be hospitalised more than once in a given year.


Figure 26 shows privately funded procedure rates by five-year age group and sex for 2009/10. The trend is similar to that for privately funded hospitalisation rates (refer to Figure 5).

Privately funded procedure rates for males and females peaked in the 65–69 year age group. In 2009/10, older males (60 years and over) and younger males (0–9 years) had higher procedure rates compared with females. The procedure rate for females aged 15–59 years was higher than that for males, largely due to gynaecological procedures (7518) and more anaesthesia procedures compared with males.14 Obstetric procedures (673) made up only a small proportion of procedures for females in this age range.

Figure 26: Age-specific privately funded hospital procedure rates by sex, 2009/10

0

1000

2000

3000

4000

5000

6000

7000

8000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Male Female

Age-specific rate



14 In 2009/10, females aged 15–59 received 20,063 anaesthesia procedures while males received 13,617.


EthnicityThis section presents ethnicity data for publicly funded hospital procedures only. Ethnicity data for private hospitals cannot be included in this publication due to the high number of procedures that have no ethnicity information recorded (see the ‘Data sources, data quality and timing issues’ section in the Introduction for further information).

Publicly funded hospital procedures for Māori accounted for 15.6% (214,395) of all publicly funded procedures in 2009/10.

Table 19 shows that Māori had higher procedure rates compared with non-Māori for each year from 1995/96 to 2009/10. It also shows that the procedure rate for Māori showed a larger increase compared with the rate for non-Māori over the 15 years to 30 June 2010 (116.8% and 87.8% respectively).

Table 19: Publicly funded hospital procedures and age-standardised rates by ethnicity, 1995/96–2009/10

Year Māori Non-Māori


1995/96 75,290 16,221.8 512,851 14,707.3

1996/97 88,785 18,893.3 590,749 16,645.7

1997/98 99,380 21,027.3 666,101 18,551.7

1998/99 103,148 21,388.5 678,623 18,816.8

1999/00 104,129 20,952.2 639,929 17,840.9

2000/01 111,491 21,773.9 665,394 18,426.0

2001/02 145,799 27,965.9 861,010 23,371.4

2002/03 153,941 29,343.5 891,010 23,607.0

2003/04 163,290 30,644.0 914,767 23,830.7

2004/05 174,926 31,911.2 954,563 24,721.0

2005/06 187,709 33,614.4 991,728 25,414.0

2006/07 197,424 34,221.2 1,029,298 26,037.6

2007/08 198,316 33,424.4 1,050,939 26,278.9

2008/09 202,343 33,782.5 1,071,418 26,138.6

2009/10 214,395 35,172.9 1,158,877 27,618.9




Figure 27 shows that the disparity between Māori and non-Māori procedure rates has generally increased over time. The greatest disparity occurred in 2005/06, when the procedure rate for Māori was 32.3% higher than the rate for non-Māori. In 2009/10, the procedure rate for Māori was 27.4% higher than the rate for non-Māori. As explained previously, the increase in the rate of procedures from 2000/01 to 2001/02 was largely due to coding changes that required anaesthesia to be coded separately.

Compared with 2008/09, Māori received approximately 1400 more procedures (per 100,000 Māori) in 2009/10. Non-Māori received approximately 1500 more procedures (per 100,000 non-Māori) in 2009/10 compared with the previous year.

Figure 27: Age-standardised hospital procedure rates by ethnicity,1999/00–2009/10

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10

Year

MāoriNon-Māori






Table 20 presents numbers and age-standardised rates of hospital procedures by ethnicity and sex. For both Māori and non-Māori, females had a higher number of procedures than males for each year from 1995/96 to 2009/10. As evident in the case of hospital discharges, Māori males experienced the greatest increase in procedure rates (147.3%) over the same time period.

Compared to 2008/09, non-Māori females had the greatest increase in procedure rates: they received 1593 more procedures (per 100,000 non-Māori females) in 2009/10.

Table 20: Publicly funded hospital procedures and age-standardised rates by ethnicity and sex, 1995/96–2009/10


Male Female Male Female


1995/96 26,500 12,482.1 48,790 19,677.8 206,842 12,072.7 306,009 17,409.5

1996/97 32,827 15,287.6 55,958 22,240.6 241,578 13,870.1 349,171 19,484.8

1997/98 37,680 17,550.6 61,700 24,325.3 276,238 15,675.7 389,863 21,489.6

1998/99 41,075 18,529.2 62,073 24,096.7 286,288 16,144.5 392,335 21,510.4

1999/00 41,494 17,888.1 62,635 23,783.8 265,819 14,937.8 374,110 20,719.6

2000/01 44,759 18,600.5 66,732 24,742.6 280,214 15,589.2 385,180 21,222.0

2001/02 61,151 24,583.0 84,648 31,074.9 373,389 20,491.9 487,621 26,219.3

2002/03 65,216 26,049.6 88,725 32,363.5 387,421 20,729.0 503,589 26,448.2

2003/04 69,854 27,604.1 93,436 33,393.5 398,234 20,926.1 516,533 26,684.5

2004/05 75,965 29,108.6 98,961 34,434.3 424,044 22,074.5 530,519 27,297.5

2005/06 82,292 30,940.5 105,417 36,059.1 444,377 22,843.2 547,351 27,888.9

2006/07 85,672 30,972.7 111,752 37,195.8 460,280 23,211.5 569,018 28,772.8

2007/08 84,469 29,610.8 113,847 36,956.6 469,063 23,275.9 581,876 29,207.5

2008/09 85,662 29,648.4 116,681 37,600.3 477,921 23,079.8 593,497 29,139.8

2009/10 91,181 30,868.1 123,214 39,168.2 518,531 24,453.2 640,346 30,732.8




Figure 28 shows age-specific hospital procedure rates for Māori and non-Māori in 2009/10. Procedure rates were higher among Māori for those aged 5–29 years and35–79 years. More specifically, the procedure rate for Māori was more than 1.5 times the rate for non-Māori for those aged 20–24 and all age groups between 45 and 69.

Note that, due to the lower Māori population in the older age groups, rates should be interpreted with care.

Figure 28: Age-specific publicly funded hospital procedure rates by ethnicity, 2009/10

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

100,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Māori Non-Māori

Age-specific rate




Figure 29 shows that procedure rates for Māori males were higher than rates for non-Māori males for all age groups except for those aged 0–4 and those aged 80 years and over in 2009/10. In particular, the procedure rate for Māori males was more than 1.5 times the rate for non-Māori males for all age groups between 45 and 69.

Note that, due to the lower population of Māori males in the older age groups, rates should be interpreted with care. Also note that rates shown are based on number of procedures. Some patients may experience more than one procedure during their hospitalisation. Patients may also be hospitalised more than once in a given year.

Figure 29: Age-specific publicly funded hospital procedure rates by ethnicity, males, 2009/10

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

100,000

110,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)


Age-specific rate




In 2009/10, Māori females had higher hospital procedure rates compared with non-Māori females for those aged 0–29 years and 40–79 years (Figure 30). The procedure rate for Māori females was more than 1.5 times the rate for non-Māori females for those aged 15–24 and 45–69 years.

Note that, due to the lower population of Māori females in the older age groups, rates should be interpreted with care.

Figure 30: Age-specific publicly funded hospital procedure rates by ethnicity, females, 2009/10

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)


Age-specific rate




DeprivationThis section presents hospital procedure rates by deprivation quintile according to the New Zealand Deprivation Index 2006 (Salmond and Crampton 2002).

Figure 31 shows that publicly funded and privately funded procedures received were not evenly spread over deprivation in 2009/10. As deprivation increased, publicly funded procedure rates increased and privately funded procedure rates decreased.

In 2009/10, the rate of publicly funded procedures for the most deprived areas was almost twice the rate for the least deprived areas of New Zealand (39,301.6 compared with 20,528.5 procedures per 100,000 people).

For privately funded procedures, the rate for the most deprived areas was less than half the rate for the least deprived areas (1569.4 compared with 3942.8 privately funded procedures per 100,000 people).

Figure 31: Publicly and privately funded procedure rates by deprivation quintile, 2009/10

0

10,000

20,000

30,000

40,000



Publicly funded hospital procedures Privately funded hospital procedures





Figure 32 shows rates of publicly funded hospital procedures by deprivation quintile and ethnicity. In 2009/10 procedure rates for Māori were significantly15 higher than those for non-Māori at all levels of deprivation. The disparity between Māori and non-Māori procedure rates was greatest in the most deprived areas of New Zealand.

Procedure rates for both Māori and non-Māori were significantly lower for the least deprived areas (quintile 1) compared with the most deprived areas (quintile 5) in 2009/10.

Figure 32: Publicly funded hospital procedure rates by ethnicity and deprivation quintile, 2009/10

0

10,000

20,000

30,000

40,000

50,000



Māori Non-Māori






District health board regionThis section presents publicly funded hospital procedure data by DHB region of residence. Note that not all residents in a particular DHB will be treated in that DHB region. Also note that it is not possible to include regional comparisons of privately funded procedures (see the ‘Data sources, data quality and timing issues’ section in the Introduction for further information).

For all DHB regions, procedures for females exceeded those for males (Table 21). Capital & Coast had the highest proportion of procedures for females (61.7%), while Northland had the highest proportion of procedures for males (49.4%) in 2009/10.

Table 21: Publicly funded hospital procedures by DHB region, 2009/10

DHB region Number Rate Percent of procedures


Northland 33,982 34,816 68,798 35,545.0 40,096.0 37,841.5 49.4 50.6 100.0

Waitemata 67,350 84,088 151,438 23,308.1 29,023.6 26,192.3 44.5 55.5 100.0

Auckland 50,401 66,673 117,074 22,652.4 26,575.5 24,655.9 43.1 56.9 100.0


Waikato 59,528 74,583 134,111 29,151.8 37,703.4 33,402.8 44.4 55.6 100.0

Lakes 15,390 18,173 33,563 27,076.2 33,606.4 30,450.6 45.9 54.1 100.0

Bay of Plenty 32,301 39,734 72,035 26,039.9 35,538.7 30,877.6 44.8 55.2 100.0

Tairawhiti 7340 8780 16,120 28,340.5 35,596.4 32,063.5 45.5 54.5 100.0

Hawke’s Bay 23,182 28,325 51,507 25,986.4 34,263.4 30,162.7 45.0 55.0 100.0

Taranaki 16,378 21,122 37,500 25,763.5 36,033.8 30,852.3 43.7 56.3 100.0

MidCentral 19,640 25,799 45,439 20,625.9 28,717.5 24,729.2 43.2 56.8 100.0

Whanganui 11,746 13,598 25,344 32,386.5 40,182.0 36,222.7 46.3 53.7 100.0

Capital & Coast 27,390 44,070 71,460 18,599.4 27,448.7 23,186.7 38.3 61.7 100.0

Hutt Valley 20,895 28,182 49,077 26,718.3 37,059.3 31,897.4 42.6 57.4 100.0

Wairarapa 6194 7397 13,591 26,434.5 35,721.8 31,075.1 45.6 54.4 100.0

Nelson Marlborough 19,823 23,833 43,656 23,656.4 33,178.6 28,354.4 45.4 54.6 100.0

West Coast 5413 5868 11,281 26,578.3 32,775.7 29,721.1 48.0 52.0 100.0

Canterbury 72,586 90,886 163,472 24,780.0 31,385.1 28,034.3 44.4 55.6 100.0

South Canterbury 9257 10,980 20,237 26,354.6 35,990.0 31,150.3 45.7 54.3 100.0

Otago 24,188 29,046 53,234 22,592.4 27,361.9 25,032.7 45.4 54.6 100.0

Southland 17,001 19,625 36,626 27,657.9 33,002.2 30,266.6 46.4 53.6 100.0


Total New Zealand 609,712 763,560 1,373,272 25,203.3 31,951.0 28,621.0 44.4 55.6 100.0




Controlling for differences in age distribution (Figures 33 and 34), all DHB regions had publicly funded procedure rates that were likely to be significantly different from the New Zealand rate (14 were higher and seven were lower).

Northland DHB region had the highest rate of publicly funded hospital procedures for the total population (37,841.5, n=68,798). Whanganui had the next highest rate (36,222.7, n=25,344), while Capital & Coast had the lowest rate (23,186.7, n=71,460).

Figure 33: Publicly funded hospital procedure rates by DHB region, 2009/10

0

10,000

20,000

30,000

40,000

Nor

thla

nd

Wai

tem

ata

Auc

klan

d

Cou

ntie

s M

anuk

au

Wai

kato

Lake

s

Bay

of P

lent

y

Taira

whi

ti

Haw

ke's

Bay

Tara

naki

Mid

Cen

tral

Wha

ngan

ui

Cap

ital &

Coa

st

Hut

t Val

ley

Wai

rara

pa

Nel

son

Mar

lbor

ough

Wes

t Coa

st

Can

terb

ury

Sou

th C

ante

rbur

y

Ota

go

Sou

thla

nd


New Zealand rate




11 of the 15 North Island DHB regions had procedure rates that were significantly higher (Northland, Whanganui, Waikato, Tairawhiti, Hutt Valley, Wairarapa, Bay of Plenty, Taranaki, Lakes, Counties Manukau, and Hawke’s Bay)

half of the South Island DHB regions had procedure rates that were significantly higher (South Canterbury, Southland and West Coast).


Figure 34: Publicly funded hospital procedure rates by DHB region, 2009/10




Table 22 presents publicly funded hospital procedure information for the Māori population by DHB region for 2009/10. It shows that of all DHB regions, Nelson Marlborough had the highest proportion of procedures for Māori females (64.4%). Southland had the highest proportion of procedures for Māori males (50.7%).

Table 22: Publicly funded hospital procedures by DHB region, Māori population, 2009/10

DHB region Number Rate Percent of procedures


Northland 12,899 13,747 26,646 57,045.2 56,165.6 56,328.9 48.4 51.6 100.0

Waitemata 6531 8501 15,032 28,113.8 35,068.6 31,667.6 43.4 56.6 100.0

Auckland 4944 6167 11,111 30,813.1 34,446.5 32,728.6 44.5 55.5 100.0


Waikato 11,437 16,510 27,947 32,699.4 43,961.5 38,513.2 40.9 59.1 100.0

Lakes 4750 6607 11,357 31,599.1 38,666.6 35,010.9 41.8 58.2 100.0

Bay of Plenty 6954 9851 16,805 29,759.9 39,788.5 34,900.7 41.4 58.6 100.0

Tairawhiti 3119 4321 7440 31,022.0 39,521.4 35,515.9 41.9 58.1 100.0

Hawke’s Bay 5022 7140 12,162 29,177.7 38,705.5 34,156.2 41.3 58.7 100.0

Taranaki 2216 3309 5525 24,816.9 39,249.9 31,872.4 40.1 59.9 100.0

MidCentral 2720 4209 6929 19,162.2 27,747.9 23,561.7 39.3 60.7 100.0

Whanganui 2382 3609 5991 31,355.5 45,592.7 38,819.3 39.8 60.2 100.0

Capital & Coast 3177 5697 8874 22,673.0 36,423.1 29,955.8 35.8 64.2 100.0

Hutt Valley 3555 4875 8430 32,224.0 41,573.1 36,859.6 42.2 57.8 100.0

Wairarapa 804 1304 2108 28,785.9 44,778.6 37,122.2 38.1 61.9 100.0

Nelson Marlborough 1135 2052 3187 17,320.0 33,715.8 25,566.3 35.6 64.4 100.0

West Coast 354 431 785 22,097.0 28,161.9 24,896.1 45.1 54.9 100.0

Canterbury 4497 5930 10,427 23,841.8 33,253.1 28,533.7 43.1 56.9 100.0

South Canterbury 351 503 854 18,046.1 30,642.7 24,059.4 41.1 58.9 100.0

Otago 1255 1590 2845 19,233.1 24,028.3 21,599.6 44.1 55.9 100.0

Southland 1959 1902 3861 29,750.2 30,517.8 30,399.6 50.7 49.3 100.0


Total New Zealand 91,181 123,214 214,395 31,027.6 39,111.6 35,214.7 42.5 57.5 100.0




According to Figures 35 and 36, most DHB regions had procedure rates for Māori that were likely to be significantly different from the national rate (six were higher and 12 were lower).

Northland DHB region had the highest rate of publicly funded procedures for the Māori population (56,328.9, n=26,646), and Whanganui had the next highest rate (38,819.3, n=5991). Tairawhiti, Lakes and Bay of Plenty had rates that were not likely to be significantly different from the New Zealand rate. The DHB region with the lowest procedure rate was Otago (21,599.6, n=2845).

Figure 35: Publicly funded hospital procedure rates by DHB region, Māori population, 2009/10

0

10,000

20,000

30,000

40,000

50,000

60,000

Nor

thla

nd

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Auc

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ntie

s M

anuk

au

Wai

kato

Lake

s

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of P

lent

y

Taira

whi

ti

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ke's

Bay

Tara

naki

Mid

Cen

tral

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ngan

ui

Cap

ital &

Coa

st

Hut

t Val

ley

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rara

pa

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son

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ough

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t Coa

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terb

ury

Sou

th C

ante

rbur

y

Ota

go

Sou

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nd


New Zealand rate




six of the 15 North Island DHB regions had procedure rates for Māori that were significantly higher (Northland, Whanganui, Waikato, Wairarapa, Hutt Valley and Counties Manukau)

all South Island DHB regions had procedure rates for Māori that were significantly lower.


Figure 36: Publicly funded hospital procedure rates by DHB region, Māori population, 2009/10




Selected proceduresThis section presents information on selected publicly and privately funded hospital procedures, classified according to the ICD-10-AM 6th Edition. Table N-3 in the ‘Technical notes’ section shows the ICD codes used to define the procedures.

Publicly funded hospital proceduresTo provide context, Figure 37 shows the number of publicly funded procedures performed in 2009/10 by sex for the 10 most common ICD chapters.

The ICD chapters with the highest number of publicly funded hospitalisations in 2009/10 were: non-invasive, cognitive and other interventions, not elsewhere

classified16 (494,295) obstetric procedures (140,279) imaging services (126,620).

16 ‘Non-invasive, cognitive and other interventions, not elsewhere classified’ (ICD chapter XIX) includes therapeutic and diagnostic interventions (such as exercise therapy, consultation and evaluation), interventions that require cognitive skills (such as counselling) and other interventions, such as anaesthesia.


Figure 37: Publicly funded hospital procedures by sex and ICD chapter, 2009/10

0 100,000 200,000 300,000 400,000 500,000

1040–1129 XI Procedures on urinary system

450–490 VI Dental services

1240–1299 XIII Gynaecological procedures

600–767 VIII Procedures on cardiovascularsystem

1600–1718 XVI Dermatological and plasticprocedures

1360–1579 XV Procedures onmusculoskeletal system

850–1011 X Procedures on digestive system

1940–2016 XX Imaging services

1330–1347 XIV Obstetric procedures

1820–1916 XIX Non-invasive, cognitive andinterventions, not elsewhere classified

ICD chapter

Male Female

Number


Two-thirds (67.4%) of publicly funded procedures in chapter XIX (non-invasive, cognitive and other interventions, not elsewhere classified) were coded as anaesthesia in 2009/10. This chapter is therefore excluded from analyses of selected procedures.

Table 23 shows age-standardised rates for selected procedures for publicly funded hospital procedures for the total population, Māori and non-Māori, by sex, in 2009/10.

Of the selected publicly funded procedures, the highest rates for the total population and the Māori population were for: cataracts grommets and myringotomies tonsils and adenoids hernia procedures.


Table 23: Age-standardised publicly funded hospital procedure rates for selected procedures by sex and ethnicity, 2009/10

Procedures Total population Māori population Non-Māori population


Carpal and tarsal tunnel procedures

59.0 86.9 73.4 64.6 113.4 90.4 58.4 83.7 71.4

Cataracts 179.4 204.1 192.3 301.2 316.6 309.4 169.0 194.4 182.2

Cholecystectomies 57.6 148.2 103.7 71.3 205.2 141.2 55.4 137.9 97.2

Coronary angioplasties 132.3 41.8 85.5 102.2 48.4 73.7 134.0 40.8 85.9

Coronary artery bypass grafts

94.6 21.9 57.0 107.6 42.1 73.0 92.3 19.8 54.8

Grommets and myringotomies

218.7 158.8 189.5 250.4 178.8 215.7 210.3 154.2 182.9

Hernia 254.1 69.6 159.4 275.3 73.7 170.2 250.6 69.7 157.9

Hip replacements 74.7 83.3 79.9 99.5 96.8 98.4 71.7 81.2 77.4

Hysterectomies 0.0 119.2 61.8 0.0 157.1 83.3 0.1 114.0 58.9

Knee replacements 55.8 63.4 59.7 68.6 54.3 61.3 54.5 64.0 59.4

Prostatectomies 78.4 0.0 36.8 63.4 0.0 29.2 79.3 0.0 37.4

Tonsils and adenoids 188.5 184.5 186.6 170.4 156.3 163.7 196.5 194.4 195.5

Varicose veins 19.2 17.5 18.4 53.4 40.9 46.7 15.3 14.5 14.9

All procedures 25,218.2 31,937.8 28,617.5 30,868.1 39,168.2 35,172.9 24,453.2 30,732.8 27,618.9



Sex-based differences in publicly funded hospital proceduresOverall, females had a higher age-standardised rate for publicly funded hospital procedures compared with males. Obstetric procedures were a large component (18.4%) of female hospital procedures.Table 23 shows that in 2009/10 females had: over 2.5 times the male hospital procedure rate for cholecystectomies higher rates for carpal and tarsal tunnel procedures, cataracts, knee

replacements and hip replacements compared with males.

In 2009/10, males had: over four times the female procedure rate for coronary artery bypass

grafts more than 3.5 times the female rate for hernia procedures over three times the female rate for coronary angioplasties a higher rate for grommets and myringotomies compared with females.


Ethnicity-based differences in publicly funded hospital proceduresMāori had higher hospital procedure rates than non-Māori for most selected procedures (Table 23). In 2009/10, Māori had: over three times the non-Māori rate for varicose veins procedures over 1.5 times the non-Māori rate for cataract procedures higher rates for cholecystectomies, hysterectomies, coronary artery

bypass grafts, hip replacements, carpal and tarsal tunnel procedures, grommets and myringotomies, and hernia procedures compared with non-Māori.

Non-Māori had higher procedure rates for prostatectomies, tonsils and adenoids, and coronary angioplasties compared with Māori in 2009/10.

Table 23 also shows that compared to non-Māori females, Māori females had: almost three times the rate for varicose veins procedures more than twice the rate for coronary artery bypass grafts approximately 1.5 times the rates for cataracts and cholecystectomies

procedures.

Compared to non-Māori males, Māori males had: over three times the rate for varicose veins procedures over 1.5 times the rate for cataracts almost 1.5 times the rate for hip replacement procedures.

Compared with Māori females, Māori males had over 3.5 times the rate for hernia procedures, over 2.5 times the rate for coronary artery bypass grafts and over twice the rate for coronary angioplasties in 2009/10. Conversely, Māori females had almost three times the rate for cholecystectomies compared with Māori males in the same year.

Compared with non-Māori females, non-Māori males had over 4.5 times the rate for coronary artery bypass grafts, over 3.5 times the rate for hernia procedures and over three times the rate for coronary angioplasties. On the other hand, non-Māori females had approximately 2.5 times the procedure rate for cholecystectomies compared with non-Māori males.


Privately funded hospital proceduresTo provide context, Figure 38 shows the number of privately funded procedures performed in 2009/10 for the 10 most common ICD chapters.

The ICD chapters with the highest number of privately funded hospital procedures were: non-invasive, cognitive and other interventions, not elsewhere

classified17 (62,767) procedures on digestive system (21,069) procedures on musculoskeletal system (14,534) gynaecological procedures (8644).

Figure 38: Privately funded hospital procedures by sex and ICD chapter, 2009/10

0 10,000 20,000 30,000 40,000 50,000 60,000 70,000

1–86 I Procedures on nervous system

600–767 VIII Procedures on cardiovascularsystem

300–333 IV Procedures on ear and mastoidprocess

1600–1718 XVI Dermatological and plasticprocedures

160–256 III Procedures on eye and adnexa

370–422 V Procedures on nose, mouth andpharynx

1240–1299 XIII Gynaecological procedures

1360–1579 XV Procedures onmusculoskeletal system

850–1011 X Procedures on digestive system

1820–1916 XIX Non-invasive, cognitive andinterventions, not elsewhere classified

ICD chapter

Male Female

Number


Almost all (97.5%) privately funded procedures coded to chapter XIX (non-invasive, cognitive and other interventions, not elsewhere classified) were coded as anaesthesia in 2009/10. This chapter is therefore excluded from the analyses of selected procedures.

17 ‘Non-invasive, cognitive and other interventions, not elsewhere classified’ (ICD chapter XIX) includes therapeutic and diagnostic interventions (such as exercise therapy, consultation and evaluation), interventions that require cognitive skills (such as counselling) and other interventions such as anaesthesia.


Table 24 shows age-standardised rates for selected privately funded hospital procedures for the total population18 in 2009/10. Of the selected procedures, rates were highest for: tonsils and adenoids grommets and myringotomies cataracts hernia procedures.

Table 24: Age-standardised privately funded hospital procedure rates for selected procedures by sex, 2009/10

Procedures Total population

Male Female Total

Carpal and tarsal tunnel procedures 20.4 25.3 22.9

Cataracts 64.0 79.2 71.7

Cholecystectomies 12.4 33.3 23.2

Coronary angioplasties 4.6 1.4 2.9

Coronary artery bypass grafts 4.9 0.6 2.7

Grommets and myringotomies 87.5 62.8 75.5

Hernia 90.3 17.9 53.0

Hip replacements 30.8 25.7 28.2

Hysterectomies 0.0 51.2 26.5

Knee replacements 21.3 18.5 19.8

Prostatectomies 30.7 0.0 14.7

Tonsils and adenoids 79.7 89.1 84.4

Varicose veins 25.0 38.0 31.7

All procedures 2664.0 3176.7 2926.8



18 Ethnicity data for privately funded hospitalisations are not shown due to the high number of privately funded hospital discharges that have no ethnicity information recorded.


Sex-based differences in privately funded hospital proceduresOverall, females had a higher age-standardised rate for privately funded hospital procedures compared with males. However, for over half of the selected procedures included (Table 24), rates for males were higher than female rates. For example, in 2009/10 males had: over eight times the female rate for coronary artery bypass grafts over five times the female rate for hernia procedures over three times the female rate for coronary angioplasties higher rates for grommets and myringotomies, hip replacements and

knee replacements compared with females.

In 2009/10 females had: over 2.5 times the male procedure rate for cholecystectomies over 1.5 times the male rate for varicose veins higher rates for carpal and tarsal tunnel procedures, cataracts and

tonsil and adenoid procedures compared with males.


Length of stayThis section focuses on the average length of stay (number of days) in hospital for publicly funded and privately funded hospital procedures. It presents data for inpatients, and excludes day cases (patients hospitalised for zero days and discharged routinely). See the ‘Definitions’ section for a detailed explanation of length of stay.

Table 25 shows that for publicly funded procedures, non-Māori spent slightly longer in hospital compared with Māori in 2009/10 (7.5 days compared with 7.3 days on average). In this year, non-Māori females spent longer in hospital compared with Māori females, while Māori males spent longer than non-Māori males.

The average length of stay in hospital for publicly funded procedures fell from 8.0 days to 7.4 days from 1995/96 to 2009/10. Over the same time period, the average length of stay decreased for non-Māori and increased for Māori.

Table 25: Average length of stay and total bed days by sex and ethnicity, publicly funded hospital procedures, 1995/96 and 2009/10

1995/96 2009/10



Māori 9.6 5.4 6.9 9.0 6.1 7.3

Non-Māori 9.7 7.1 8.2 8.5 6.7 7.5

Total 9.7 6.9 8.0 8.5 6.6 7.4


For privately funded hospital procedures, the average length of stay fell slightly from 2.9 days in 2004/05 to 2.6 days in 2009/10 (Table 26). Females spent less time in hospital than males for privately funded procedures in 2009/10.

The average length of stay for privately funded procedures was 4.8 days less than for publicly funded procedures in 2009/10.

Table 26: Average length of stay and total bed days by sex and ethnicity, privately funded hospital procedures, 2004/05 and 2009/10

2004/05 2009/10




Total 2.9 2.9 2.9 2.7 2.5 2.6


Note: Ethnicity data for privately funded hospital discharges is not included due to the high number of discharges that have no ethnicity information recorded.

Figure 39 shows the average length of stay for hospital procedures by deprivation quintile. The average length of stay in hospital for publicly funded procedures was longer for all deprivation quintiles compared with privately funded procedures in 2009/10.

For publicly funded procedures, the least deprived areas had a shorter length of stay in hospital compared with the rest of the New Zealand in 2009/10 (7.1 days on average). For the remaining deprivation quintiles, the average length of stay was comparable at around 7.5 days.

For privately funded procedures, the average length of stay was lowest in the second least deprived areas (quintile 2) and highest in the most deprived areas (quintile 5).

Figure 39: Average length of stay, hospital procedures, 2009/10

7.17.5 7.4 7.6 7.5

2.3 2.2 2.42.6

3.1

0

2

4

6

8

10



Publicly funded hospital procedures

Privately funded hospital procedures



Table 27 shows the average length of stay for publicly funded hospital procedures by DHB region in 2009/10. For the total population, Waikato had the longest average length of stay of all DHB regions (8.6 days), while Nelson Marlborough had the shortest (5.9 days). Compared to New Zealand as a whole:


four DHB regions in the North Island had a longer average length of stay (Waikato, Auckland, Bay of Plenty and Hawke’s Bay)

half of South Island DHB regions had a longer average length of stay (Otago, South Canterbury and Canterbury).

For Māori, Otago had the longest average length of stay for all DHB regions (11.6 days), while Nelson Marlborough had the shortest (5.9 days). Compared to New Zealand as a whole:

two DHB regions in the South Island had a longer average length of stay (Otago and Southland)

three DHB regions in the North Island had a longer average length of stay (Auckland, Waikato and Northland).

Table 27: Average length of stay by ethnicity and DHB region, publicly funded hospital procedures, 2009/10

DHB region Total population Māori population


Northland 8.4 6.4 7.4 9.3 6.5 7.8

Waitemata 8.1 6.1 6.9 8.4 5.5 6.7

Auckland 10.3 6.5 8.1 12.1 6.4 8.9

Counties Manukau 8.2 6.2 7.0 9.2 5.3 6.9

Waikato 9.5 7.8 8.6 9.6 7.5 8.4

Lakes 7.2 5.9 6.5 7.4 6.5 6.9

Bay of Plenty 9.1 6.9 7.9 9.4 5.4 7.2

Tairawhiti 8.2 6.1 7.0 8.5 5.9 7.0

Hawke’s Bay 8.6 6.7 7.6 8.7 5.8 7.0

Taranaki 8.0 6.1 7.0 8.9 5.1 6.7

MidCentral 8.0 6.8 7.3 7.4 5.3 6.1

Whanganui 6.0 6.2 6.1 6.9 6.1 6.4

Capital & Coast 9.1 6.3 7.4 8.8 6.1 7.1

Hutt Valley 7.8 6.5 7.0 7.9 5.4 6.5

Wairarapa 6.7 5.4 6.0 6.2 6.1 6.1

Nelson Marlborough 6.2 5.6 5.9 4.2 6.7 5.9

West Coast 7.3 6.1 6.7 8.5 4.3 6.0

Canterbury 8.7 6.6 7.5 8.6 5.6 6.9

South Canterbury 8.2 7.0 7.6 3.4 8.0 6.4

Otago 8.7 7.9 8.3 9.9 12.9 11.6

Southland 8.5 6.5 7.4 10.9 4.0 7.4

Overseas and undefined 9.0 9.4 9.2 7.7 6.8 7.3

Total New Zealand 8.5 6.6 7.4 9.0 6.1 7.3



Inpatients and day casesThis section presents hospital procedures by patient type: inpatients and day cases.

For this publication a day case is defined as a patient hospitalised for zero days and discharged routinely. An inpatient is a patient that does not fit the day case criteria. See the ‘Definitions’ section for more detailed explanations of inpatients and day cases.

In 2009/10, day cases made up one-third (33.9%) of publicly funded hospital procedures; the remaining 66.1% were inpatients (Table 28). The proportion of day cases was higher for privately funded procedures. Day cases made up over half of all privately funded hospital procedures from 2004/05 to 2009/10.

The number of publicly funded day case procedures in 2009/10 was more than three times that in 1995/96. Furthermore, the proportion of day cases increased from one-quarter of procedures in 1995/96 to one-third in 2009/10. Some of this increase is due to some DHBs reporting short-stay emergency department events that were previously considered outpatient events. As explained previously, the increase in procedures from 2000/01 to 2001/02 was largely due to coding changes that required anaesthesia to be coded separately.

Table 28: Hospital procedures by patient type, 1995/96–2009/10

Year Publicly funded hospital procedures Privately funded hospital procedures

Inpatient Day case % day case Inpatient Day case % day case

1995/96 441,013 147,128 25.0

1996/97 515,041 164,493 24.2

1997/98 576,630 188,851 24.7

1998/99 578,835 202,936 26.0

1999/00 542,629 201,429 27.1

2000/01 556,630 220,255 28.4

2001/02 707,907 298,902 29.7

2002/03 733,754 311,197 29.8

2003/04 757,207 320,850 29.8

2004/05 761,755 367,734 32.6 68,995 93,336 57.5

2005/06 786,367 393,070 33.3 74,110 101,685 57.8

2006/07 803,102 423,620 34.5 73,055 97,373 57.1


2007/08 823,288 425,967 34.1 66,422 82,015 55.3

2008/09 839,210 434,551 34.1 73,614 85,659 53.8

2009/10 908,244 465,028 33.9 66,467 80,227 54.7


Figure 40 shows age-specific rates for publicly funded inpatient and day case procedures in 2009/10. Those aged 85 years and over had the highest inpatient rate (67,060.9 per 100,000 people) while those aged 80–84 years had the highest day case rate (26,555.6 per 100,000).

The rate of inpatient procedures was greater than day case procedures for all age groups except for those aged 5–9 years. Furthermore, the inpatient rate was:

more than three times the corresponding rate for day cases for those aged25–34 years and 85 years and over

more than twice the rate for day cases for those aged 15–24 years, 35–39 years and 65–84 years.

Figure 40: Age-specific publicly funded hospital procedure rates by patient type, 2009/10

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Inpatient Day case

Age-specific rate




Figure 41 shows age-specific rates for privately funded inpatient and day case procedure rates for 2009/10. Those aged 65–69 years had the highest inpatient rate (3531.4 per 100,000 people) while those aged 80–84 had the highest day case rate (3967.3 per 100,000).

The rate of day case procedures was greater than inpatient procedures for most age groups except for those aged 30–44 and 60–64 years. More specifically, the day case rate was: more than four times the inpatient rate for those aged 5–9 years 3.5 times the inpatient rate for those aged 0–4 years more than twice the rate for inpatients for those aged 10–14 and 85

years and over.

Figure 41: Age-specific privately funded hospital procedure rates by patient type, 2009/10

0

500

1000

1500

2000

2500

3000

3500

4000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Inpatient Day case

Age-specific rate




Figure 42 shows inpatient procedure rates by five-year age group and ethnicity for 2009/10. The rate of inpatient procedures was greater for Māori compared with non-Māori for most age groups except for those aged 0–4, 30–39 and 75 years and over. The greatest disparities between Māori and non-Māori inpatient procedure rates occurred in those aged 15–24 years and 45–69 years (where the rate for Māori was more than 1.5 times the rate for non-Māori).

Note that due to the lower Māori population in the older age groups, rates should be interpreted with care.

Figure 42: Age-specific publicly funded hospital procedure rates by ethnicity, inpatients, 2009/10

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)


Age-specific rate




Figure 43 shows that the rate of day case procedures for Māori was greater than non-Māori for most age groups except those aged 10–14 and 80 years and over. The greatest disparities between Māori and non-Māori day case procedure rates occurred in:

those aged 60–64 years (where the rate for Māori was almost twice the rate for non-Māori)

those aged 20–29, 55–59 and 65–69 years (where the rate for Māori was more than 1.5 times the rate for non-Māori).

Note that due to the lower Māori population in the older age groups, rates should be interpreted with care.

Figure 43: Age-specific publicly funded hospital procedure rates by ethnicity, day cases, 2009/10

0

5,000

10,000

15,000

20,000

25,000

30,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)


Age-specific rate




Figure 44 shows publicly funded hospital procedure rates by deprivation quintile and patient type for 2009/10. Controlling for differences in age distribution, rates for both inpatient and day case procedures increased as deprivation increased. For the most deprived areas (quintile 5), both inpatient and day case rates were approximately twice the rates for the least deprived areas (quintile 1).

At all levels of deprivation, inpatient rates were higher than day case rates. The greatest disparity occurred in the least deprived areas of New Zealand, where the inpatient procedure rate was twice the rate for day case procedures.

Figure 44: Publicly funded hospital procedures by deprivation quintile and patient type, 2009/10

0

5,000

10,000

15,000

20,000

25,000

30,000



Inpatient Day case





Figure 45 shows privately funded hospital procedure rates by deprivation quintile and patient type for 2009/10. Controlling for differences in age distribution, rates for both inpatient and day case procedures decreased as deprivation increased. For the least deprived areas (quintile 1), the inpatient rate was more than twice the rate for the most deprived areas (quintile 5). For day case procedures, the rate for the least deprived areas was almost three times the rate for the most deprived areas.

At all levels of deprivation, day case rates were higher than inpatient rates. This disparity was greatest in the least deprived areas of New Zealand, where the day case procedure rate was 1.4 times the inpatient rate.

Figure 45: Privately funded hospital procedures by deprivation quintile and patient type, 2009/10

0

500

1000

1500

2000

2500



Inpatient Day case





Hospital discharges involving injury and poisoningThis chapter presents statistics on publicly funded discharges involving injury and poisoning from New Zealand hospitals. The discharges are classified according to the ‘External causes of morbidity and mortality’ chapter (ICD codes U50–Y98) of the ICD-10-AM 6th Edition. This external causes chapter allows the classification of environmental events and circumstances as the cause of injury, poisoning and other adverse events. It should be noted that data for private hospitals cannot be included in this publication because the Ministry of Health receives less external cause information from privately funded hospitals than publicly funded hospitals (see the ‘Data sources, data quality and timing issues’ section in the Introduction for further information).

OverviewThere were 180,042 hospitalisations involving injury and poisoning in 2009/10 (Table 29). Of all publicly funded hospitalisations, those involving injury and poisoning made up 17.4%. The number of hospitalisations involving injury and poisoning has almost doubled over the past 15 years.

The number of hospitalisations relative to the population was 3595.1 per 100,000 people in 2009/10. There were 87 more hospitalisations per 100,000 people in 2009/10 compared with 2008/09.

In 2009/10, 137,214 people were discharged 180,042 times from New Zealand hospitals for reasons involving injury and poisoning. Of these hospitalisations, 39.6% (71,258) were for patients who were treated more than once in 2009/10.

Multiple hospitalisations include transfers, readmissions and separate incidents. It should be noted that DHBs’ reporting practices for emergency department patients have been changing between 1999 and 2010. Some DHBs started reporting short-stay emergency department events (where people are only seen in the emergency department and discharged) when previously they did not.


SexEach year more males are hospitalised for reasons involving injury and poisoning compared with females. There were 112 male hospitalisations for every 100 female hospitalisations in 2009/10. In this year, males accounted for 53.0% of all hospitalisations involving injury and poisoning.

Table 29 shows the number of publicly funded hospitalisations involving injury and poisoning and age-standardised rates by sex from 1995/96 to 2009/10. In 2009/10, there were 95,460 male hospitalisations involving injury and poisoning (4093.7 hospitalisations per 100,000 males) and 84,582 female hospitalisations involving injury and poisoning (3093.2 hospitalisations per 100,000 females).

Accounting for changes in the New Zealand population, the rate of hospitalisations involving injury and poisoning increased by 53.3% from 1995/96 to 2009/10.

Table 29: Hospital discharges involving injury and poisoning and age-standardised rates by sex, 1995/96–2009/10



1995/96 52,246 2816.4 40,100 1864.0 92,346 2344.5

1996/97 54,102 2865.1 43,949 1979.3 98,051 2427.3

1997/98 57,488 3007.3 47,651 2113.9 105,139 2562.4

1998/99 58,976 3058.0 50,214 2187.5 109,190 2624.3

1999/00 63,608 3258.3 54,052 2314.3 117,660 2786.0

2000/01 70,277 3581.4 60,610 2594.7 130,887 3087.3

2001/02 72,408 3614.1 61,625 2567.9 134,033 3090.3

2002/03 72,286 3509.5 63,413 2573.4 135,699 3042.0

2003/04 73,261 3491.3 64,608 2569.6 137,869 3030.4

2004/05 76,406 3580.2 66,414 2588.7 142,820 3083.5

2005/06 81,763 3777.7 70,394 2710.2 152,157 3243.1

2006/07 83,781 3800.9 72,662 2772.1 156,443 3284.5

2007/08 85,406 3806.5 73,506 2766.3 158,912 3284.7

2008/09 92,524 4054.2 79,474 2961.6 171,998 3507.3

2009/10 95,460 4093.7 84,582 3093.2 180,042 3595.1




Figure 46 shows that males had a consistently higher rate of hospitalisations involving injury and poisoning than females from 1999/00 to 2009/10. Over this time period, the rate increased by 33.7% for females and 25.6% for males.

There were 131 more female hospitalisations involving injury and poisoning (per 100,000 females) and 39 more male hospitalisations (per 100,000 males) in 2009/10 compared with 2008/09.

Figure 46: Age-standardised hospital discharge rates involving injury and poisoning by sex, 1995/96–2009/10

0

500

1000

1500

2000

2500

3000

3500

4000

4500

1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10

Year

Male hospitalisations involving injury and poisoningFemale hospitalisations involving injury and poisoning





AgeTable 30 shows that the number of hospitalisations involving injury and poisoning peaked in those aged 75 years and over. This age group made up 23.3% (41,995) of hospitalisations, followed by those aged 15–24 years (12.9% or 23,204) in 2009/10.

Those aged 85 years and over had the highest rate of hospitalisations involving injury and poisoning in 2009/10. Within this age group, there were more than 25,000 hospitalisations per 100,000 females and over 22,000 hospitalisations per 100,000 males.

Table 30: Hospital discharges involving injury and poisoning by five-year age group and sex, 2009/10

Age group (years)

Male Female Total


0–4 5,070 3168.4 3,860 2542.3 8,930 2863.6

5–9 3,705 2522.1 2,731 1951.8 6,436 2243.9

10–14 4,660 3074.3 2,450 1698.9 7,110 2403.8

15–19 7,397 4469.2 4,467 2847.4 11,864 3680.0

20–24 7,236 4483.8 4,104 2667.7 11,340 3597.5

25–29 4,988 3483.7 3,324 2288.8 8,312 2882.0

30–34 4,222 3264.5 3,264 2331.6 7,486 2779.5

35–39 4,811 3364.3 3,993 2522.6 8,804 2922.1

40–44 5,131 3436.0 4,030 2481.5 9,161 2938.8

45–49 5,312 3402.1 4,401 2642.8 9,713 3010.2

50–54 5,155 3614.0 4,233 2843.8 9,388 3220.8

55–59 5,002 4052.5 4,103 3207.7 9,105 3622.6

60–64 5,505 4867.8 4,632 3951.5 10,137 4401.5

65–69 5,168 6010.0 4,607 5105.8 9,775 5547.0

70–74 5,316 8117.3 5,170 7234.8 10,486 7656.8

75–79 5,811 11,888.3 6,156 10,934.3 11,967 11,377.6

80–84 5,640 16,206.9 7,492 16,318.9 13,132 16,270.6

85+ 5,331 22,296.1 11,565 25,043.3 16,896 24,106.1

All ages 95,460 4451.2 84,582 3804.5 180,042 4122.0




Figure 47 shows rates for hospitalisations involving injury and poisoning by five-year age group and sex for 2009/10. Males had higher hospitalisation rates than females for all age groups except those aged 80 years and over. The greatest disparity between male and female rates of hospitalisations was for those aged 10–14 years, where the male rate was almost twice the female rate. From the 50–54 year age group, rates for males and females steadily increased to peak in the 85 years and over age group.

Figure 47: Age-specific rates for hospital discharges involving injury and poisoning by sex, 2009/10

0

5,000

10,000

15,000

20,000

25,000

30,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Male Female

Age-specific rate




EthnicityHospitalisations for Māori accounted for 15.1% (27,199) of all publicly funded hospitalisations involving injury and poisoning in 2009/10.

Table 31 shows that Māori had higher rates for hospitalisations involving injury and poisoning compared with non-Māori for each year from 1995/96 to 2009/10. The hospitalisation rate for Māori also showed a larger increase compared with non-Māori over this time period (82.2% compared with 47.9%).

Table 31: Hospital discharges involving injury and poisoning and age-standardised rates by ethnicity, 1995/96–2009/10



1995/96 12,020 2460.9 80,326 2332.5

1996/97 12,900 2624.8 85,151 2396.9

1997/98 13,763 2786.2 91,376 2529.3

1998/99 14,725 2930.1 94,465 2572.9

1999/00 16,229 3223.0 101,431 2718.2

2000/01 18,321 3487.7 112,566 3018.0

2001/02 18,715 3490.2 115,318 3015.2

2002/03 19,284 3572.3 116,415 2944.8

2003/04 19,552 3606.2 118,317 2933.8

2004/05 20,295 3701.2 122,525 2982.2

2005/06 22,040 3920.6 130,117 3127.1

2006/07 23,278 4051.2 133,165 3152.4

2007/08 23,162 3961.6 135,750 3168.8

2008/09 26,129 4379.2 145,869 3360.0

2009/10 27,199 4483.1 152,843 3449.8




Figure 48 shows that the disparity between Māori and non-Māori rates for hospitalisations involving injury and poisoning generally increased over the 11 years to 2009/10. The greatest disparity between rates occurred in 2008/09, when the rate for Māori was 30.3% higher than the rate for non-Māori.

There were 103 more Māori hospitalisations (per 100,000 Māori) and 89 more non-Māori hospitalisations (per 100,000 non-Māori) in 2009/10 compared to 2008/09.

Figure 48: Age-standardised rates for hospital discharges involving injury and poisoning by ethnicity, 1999/00–2009/10

0

500

1000

1500

2000

2500

3000

3500

4000

4500

5000

1999/00 2000/01 2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 2008/09 2009/10

Year

Māori Non-Māori





Māori males and non-Māori males had higher numbers and rates of hospitalisations than females for each year from 1995/96 to 2009/10 (Table 32). Hospitalisation rates for Māori males and Māori females increased more (74.5% and 93.4%) than their non-Māori counterparts (39.7% and 61.0%) over the same time period.

In 2009/10, Māori males accounted for 57.4% of hospitalisations for Māori, while non-Māori males made up 52.2% of hospitalisations for non-Māori. Compared with 2008/09, Māori females showed the greatest increase in rates: there were 170 more hospitalisations for Māori females (per 100,000 Māori females) in 2009/10.

Table 32: Hospital discharges involving injury and poisoning and age-standardised rates by ethnicity and sex, 1995/96–2009/10

Year Māori male Māori female Non-Māori male Non-Māori female


1995/96 7335 3008.7 4685 1942.3 44,911 2799.0 35,415 1852.2

1996/97 7756 3148.8 5144 2119.1 46,346 2824.6 38,805 1954.7

1997/98 8125 3295.8 5638 2295.3 49,363 2968.6 42,013 2082.8

1998/99 8600 3418.7 6125 2459.7 50,376 2999.9 44,089 2139.5

1999/00 9724 3880.0 6505 2598.5 53,884 3165.5 47,547 2267.9

2000/01 10,741 4115.8 7580 2885.9 59,536 3494.6 53,030 2539.7

2001/02 11,181 4194.3 7534 2816.7 61,227 3511.5 54,091 2516.9

2002/03 11,480 4305.3 7804 2881.4 60,806 3373.8 55,609 2511.2

2003/04 11,353 4255.7 8199 2993.1 61,908 3371.3 56,409 2493.0

2004/05 11,870 4387.0 8425 3047.6 64,536 3454.4 57,989 2507.6

2005/06 13,092 4776.1 8948 3135.5 68,671 3623.8 61,446 2626.6

2006/07 13,567 4799.0 9711 3344.0 70,214 3635.2 62,951 2669.4

2007/08 13,421 4704.8 9741 3267.6 71,985 3665.0 63,765 2671.8

2008/09 15,236 5215.4 10,893 3586.7 77,288 3866.7 68,581 2850.3

2009/10 15,619 5250.3 11,580 3757.3 79,841 3910.1 73,002 2982.8




Figure 49 shows age-specific rates for hospitalisations involving injury and poisoning for Māori and non-Māori in 2009/10. Hospitalisation rates were higher for Māori for most age groups except 0–4 years and 80 years and over. Rates for Māori males aged 25–34 and 50–69 years were more than 1.5 times the rates for non-Māori. Rates were similar for Māori and non-Māori males aged 0–4 years and 75–79 years.


Figure 49: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, 2009/10

0

5,000

10,000

15,000

20,000

25,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Māori Non-Māori

Age-specific rate




For males, rates of hospitalisations involving injury and poisoning were higher for Māori compared with non-Māori for those aged 5–79 years in 2009/10 (Figure 50). More specifically, rates for Māori males aged 25–69 years were more than 1.5 times those for non-Māori males. Rates were similar for Māori and non-Māori males aged0–4 years.

Note that, due to the lower Māori male population in the older age groups, rates should be interpreted with care.

Figure 50: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, males, 2009/10

0

5,000

10,000

15,000

20,000

25,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)


Age-specific rate




For females, rates for hospitalisations involving injury and poisoning were higher for Māori compared with non-Māori aged 0–74 years in 2009/10 (Figure 51). More specifically, Māori females aged 25–29 and 55–69 years had rates that were more than 1.5 times those for non-Māori females. Rates were similar for Māori and non-Māori females aged 0–14 years.

Note that, due to the lower Māori female population in the older age groups, rates should be interpreted with care.

Figure 51: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, females, 2009/10

0

5,000

10,000

15,000

20,000

25,000

30,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)


Age-specific rate




DeprivationThis section presents data for publicly funded hospitalisations involving injury and poisoning by deprivation quintile according to the New Zealand Deprivation Index 2006 (Salmond and Crampton 2002).

Figure 52 shows that, as deprivation increased, hospitalisation rates involving injury and poisoning also increased in 2009/10.

The hospitalisation rate for the most deprived areas was almost twice the rate for the least deprived areas of New Zealand (4950.7 compared with 2593.4 hospitalisations per 100,000 people) in 2009/10.

Figure 52: Rates for hospital discharges involving injury and poisoning by deprivation quintile, 2009/10

0

1000

2000

3000

4000

5000







Figure 53 shows rates of hospitalisations involving injury and poisoning by deprivation quintile and ethnicity. In 2009/10, rates for Māori were significantly19 higher than rates for non-Māori at all levels of deprivation. The disparity between Māori and non-Māori hospitalisation rates was greatest in the most deprived areas of New Zealand (quintile 5).

For both Māori and non-Māori, rates for the most deprived areas were almost twice the corresponding rates for the least deprived areas in 2009/10.

Figure 53: Rates for hospital discharges involving injury and poisoning by ethnicity and deprivation quintile, 2009/10

0

1000

2000

3000

4000

5000

6000



Māori Non-Māori






District health board regionThis section presents data for publicly funded hospitalisations involving injury and poisoning by DHB region of residence. Note that not all residents in a particular DHB will be treated in that DHB region.

Table 33 shows that of all DHB regions, Southland had the highest proportion of male hospitalisations (56.4%), while Capital & Coast had the highest proportion of female hospitalisations (51.9%) in 2009/10. Most DHB regions had a higher number of male hospitalisations compared with females (except for Capital & Coast, Canterbury and South Canterbury).

Table 33: Hospital discharges involving injury and poisoning by DHB region, 2009/10



Northland 4053 3275 7328 4789.7 3419.6 4097.4 55.3 44.7 100.0

Waitemata 12,760 11,293 24,053 4575.4 3460.1 4019.9 53.0 47.0 100.0

Auckland 10,431 9157 19,588 4596.3 3459.5 4028.8 53.3 46.7 100.0

Counties Manukau 10,606 8769 19,375 4353.9 3243.7 3794.9 54.7 45.3 100.0

Waikato 8317 7193 15,510 4334.5 3258.2 3797.0 53.6 46.4 100.0

Lakes 2719 2223 4942 5091.9 3572.0 4328.8 55.0 45.0 100.0

Bay of Plenty 4975 4263 9238 4356.8 3079.0 3712.9 53.9 46.1 100.0

Tairawhiti 1306 1103 2409 5464.3 3993.9 4706.2 54.2 45.8 100.0

Hawke’s Bay 3441 2712 6153 4324.6 2806.8 3563.3 55.9 44.1 100.0

Taranaki 2444 2086 4530 4077.4 2892.5 3495.0 54.0 46.0 100.0

MidCentral 3345 3242 6587 3693.4 2922.3 3315.1 50.8 49.2 100.0

Whanganui 1792 1430 3222 5380.5 3525.6 4451.5 55.6 44.4 100.0

Capital & Coast 4860 5245 10,105 3215.8 2907.2 3070.3 48.1 51.9 100.0

Hutt Valley 2282 2066 4348 3005.6 2309.0 2658.5 52.5 47.5 100.0

Wairarapa 977 763 1740 4573.1 2719.6 3648.8 56.1 43.9 100.0

Nelson Marlborough 2863 2390 5253 3625.8 2586.0 3113.6 54.5 45.5 100.0

West Coast 667 521 1188 3653.5 2513.7 3101.0 56.1 43.9 100.0

Canterbury 9168 9285 18,453 3205.8 2716.3 2965.4 49.7 50.3 100.0

South Canterbury 1053 1063 2116 3148.2 2436.7 2801.1 49.8 50.2 100.0

Otago 4030 3841 7871 3595.3 2812.2 3202.6 51.2 48.8 100.0

Southland 2522 1949 4471 4094.9 2709.2 3415.8 56.4 43.6 100.0


Total New Zealand 95,460 84,582 180,042 4095.2 3092.1 3594.9 53.0 47.0 100.0




Controlling for differences in age distribution, the majority of DHB regions had rates for hospitalisations involving injury and poisoning that were significantly different from the New Zealand rate: nine were higher and nine were lower (Figure 54).

The DHB region with the highest rate of hospitalisations involving injury and poisoning for the total population was Tairawhiti (4706.2, n=2409). Whanganui (4451.5, n=3222) and Lakes (4328.8, n=4942) had the next highest rates. Wairarapa, Hawke’s Bay and Taranaki had rates that were not significantly different to the national rate, while Hutt Valley had the lowest rate (2658.5, n=4348).

Figure 54: Hospital discharges involving injury and poisoning by DHB region, 2009/10

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5000

Nor

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New Zealand rate



Figure 55 presents the same information as Figure 54 and shows that compared to New Zealand as a whole:

all DHB regions in the South Island had rates for hospitalisations involving injury and poisoning that were significantly lower

nearly two-thirds of DHB regions in the North Island had hospitalisation rates that were significantly higher (Tairawhiti, Whanganui, Lakes, Northland, Auckland, Waitemata, Waikato, Counties Manukau and Bay of Plenty)


three DHB regions in the North Island had hospitalisation rates that were significantly lower (Hutt Valley, Capital & Coast and MidCentral).

Figure 55: Hospital discharges involving injury and poisoning by DHB region, 2009/10




Table 34 presents information on hospitalisations involving injury and poisoning for the Māori population by DHB region in 2009/10. It shows that of all DHB regions, Southland had the highest proportion of hospitalisations for Māori males (64.8%). Capital & Coast had the highest proportion of hospitalisations for Māori females (48.9%). All DHB regions had a higher number of Māori male hospitalisations involving injury and poisoning compared with those for Māori females.

Table 34: Hospital discharges involving injury and poisoning by DHB region, Māori population, 2009/10



Northland 1384 1038 2422 6025.6 4166.4 5070.2 57.1 42.9 100.0

Waitemata 1477 1066 2543 6184.8 4720.4 5458.4 58.1 41.9 100.0

Auckland 1150 868 2018 7158.4 5059.9 6042.5 57.0 43.0 100.0

Counties Manukau 2065 1661 3726 6287.7 4473.7 5282.4 55.4 44.6 100.0

Waikato 1888 1407 3295 5330.8 3835.5 4566.0 57.3 42.7 100.0

Lakes 940 689 1629 6666.4 4156.2 5213.2 57.7 42.3 100.0

Bay of Plenty 1228 866 2094 5382.9 3451.1 4343.8 58.6 41.4 100.0

Tairawhiti 609 470 1079 6276.1 4248.9 5188.4 56.4 43.6 100.0

Hawke’s Bay 938 602 1540 5478.0 3223.2 4293.9 60.9 39.1 100.0

Taranaki 388 263 651 4589.9 3328.8 3982.5 59.6 40.4 100.0

MidCentral 540 380 920 3760.9 2629.0 3192.7 58.7 41.3 100.0

Whanganui 392 311 703 5399.2 3986.8 4700.0 55.8 44.2 100.0

Capital & Coast 570 546 1116 4061.5 3898.8 3989.1 51.1 48.9 100.0

Hutt Valley 440 288 728 4085.4 2655.1 3331.1 60.4 39.6 100.0

Wairarapa 145 90 235 5240.8 3207.2 4193.2 61.7 38.3 100.0

Nelson Marlborough 183 161 344 2872.1 2649.5 2785.8 53.2 46.8 100.0

West Coast 57 32 89 3560.3 2133.7 2824.9 64.0 36.0 100.0

Canterbury 622 479 1101 3284.8 2708.2 2992.6 56.5 43.5 100.0

South Canterbury 59 33 92 3161.1 2049.9 2590.1 64.1 35.9 100.0

Otago 240 157 397 3636.4 2557.8 3102.3 60.5 39.5 100.0

Southland 263 143 406 4257.3 2511.8 3413.5 64.8 35.2 100.0


Total New Zealand 15,619 11,580 27,199 5273.4 3759.4 4493.8 57.4 42.6 100.0




As shown in Figure 56, most DHB regions had rates for hospitalisations involving injury and poisoning for the Māori population that were likely to be significantly different from the national rate (six were higher and 10 were lower).

Auckland had the highest rate of hospitalisations involving injury and poisoning for the Māori population (6042.5, n=2018). Waitemata had the second highest rate (5458.4, n=2543). Whanganui, Waikato, Bay of Plenty, Hawke’s Bay and Wairarapa had hospitalisation rates that were not likely to be significantly different from the New Zealand rate. South Canterbury had the lowest rate (2590.1, n=92).

Figure 56: Hospital discharges involving injury and poisoning by DHB region, Māori population, 2009/10

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New Zealand rate




all DHB regions in the South Island had rates for hospitalisations involving injury and poisoning for Māori that were significantly lower

six North Island DHB regions had hospitalisation rates for Māori that were significantly higher (Auckland, Waitemata, Counties Manukau, Lakes, Tairawhiti and Northland)


four North Island DHB regions had hospitalisation rates that were significantly lower (Capital & Coast, Taranaki, Hutt Valley and MidCentral).


Figure 57: Hospital discharges involving injury and poisoning by DHB region, Māori population, 2009/10




Selected causesThis section presents information on hospitalisations involving injury and poisoning by selected cause. The diagnoses are selected from Chapter XX of the ICD-10-AM 6th Edition: ‘External causes of morbidity and mortality’. This chapter allows the classification of environmental events and circumstances as the cause of injury, poisoning and other adverse events.

Table 35 shows age-standardised rates for selected causes for hospitalisations involving injury and poisoning for the total population, Māori and non-Māori, by sex, in 2009/10.

Table 35: Age-standardised rates for hospital discharges involving injury and poisoning for selected causes by sex and ethnicity, 2009/10

ICD code External cause Total population Māori population Non-Māori population


V00–V99 Transport accidents 460.3 250.9 354.9 511.7 266.0 384.9 451.5 247.7 349.3

V00–V09 Pedestrian injured in transport accident

31.5 20.8 26.2 43.2 24.9 34.2 28.6 20.2 24.5

V10–V19 Pedal cyclist injured in transport accident

102.1 34.5 68.3 93.8 25.8 59.4 102.8 36.1 69.5

V20–V29 Motorcycle rider injured in transport accident

126.9 18.2 72.1 108.9 15.5 60.8 130.6 18.9 74.6

V40–V49 Car occupant injured in transport accident

127.6 121.3 124.5 171.1 162.7 166.0 120.8 112.1 116.6

W00–W19 Falls 899.7 787.5 852.7 911.1 681.2 798.2 890.6 789.2 849.4

W01 Fall on same level from slipping, tripping and stumbling

173.4 243.0 212.3 154.4 168.0 163.1 174.1 247.7 215.0

W20–W49 Exposure to inanimate mechanical forces

551.4 221.8 385.2 711.9 277.7 487.6 522.0 210.5 365.4

W50–W64 Exposure to animate mechanical forces

166.2 75.8 121.1 242.4 101.1 169.7 152.2 69.9 111.4

X40–X49 Accidental poisoning by and exposure to noxious substances

68.7 62.1 65.3 94.8 78.1 85.6 66.2 59.9 63.1

X60–X84 Intentional self-harm 101.6 207.5 154.7 139.5 216.4 178.3 94.8 204.6 149.7

X85–Y09 Assault 218.9 76.2 147.4 462.7 235.1 345.1 174.8 44.5 109.9

Y40–Y84 Complications of medical and surgical care

1104.6 1083.4 1089.9 1484.6 1484.7 1484.2 1063.5 1043.0 1048.9

All external causes 4093.7 3093.2 3595.1 5250.3 3757.3 4483.1 3910.1 2982.8 3449.8




Sex-based differences in selected causes of injury and poisoningOverall, males had a higher age-standardised rate for hospitalisations involving injury and poisoning compared with females (age-standardised rate that was 4093.7 for males and 3093.2 for females). For most selected causes, male rates were higher than female rates.

Table 35 shows that in 2009/10 males had:

almost seven times the female hospitalisation rate for motorcycle riders injured in a transport accident

almost three times the female rate for pedal cyclists injured in a transport accident and for assault

2.5 times the female rate for exposure to inanimate mechanical forces (such as striking against or being struck by objects)

over twice the female rate for exposure to animate mechanical forces (such as being hit, struck, kicked, twisted, bitten or scratched by another person or animal)

almost twice the female rate for transport accidents.

In 2009/10, females had: over twice the male hospitalisation rate for intentional self-harm20

almost 1.5 times the male rate for falls on the same level from slipping, tripping and stumbling.

Ethnicity-based differences in selected causes of injury and poisoningIn 2009/10, the rate for Māori hospitalisations involving injury and poisoning was 1.3 times the non-Māori rate (age-standardised rate that was 4483.1 for Māori and 3449.8 for non-Māori).

Māori had higher rates than non-Māori for most causes shown in Table 35. For example, in 2009/10 Māori had:

over three times the non-Māori hospitalisation rate for assault (Māori females had over five times the non-Māori female rate, while Māori males had over 2.5 times the non-Māori male rate)

1.5 times the non-Māori rate for exposure to animate mechanical forces (such as insect bites or stings)

20 Note that reported rates for intentional self-harm in this publication are not directly comparable with those reported in the Ministry of Health’s Suicide Facts: Deaths and intentional self-harm hospitalisations publications. For more information please refer to the ‘Definitions’ section.


higher hospitalisation rates for most other selected causes, including car occupants injured in a transport accident, complications of medical and surgical care, pedestrians injured in a transport accident, accidental poisoning and exposure to inanimate mechanical forces.

In 2009/10, non-Māori hospitalisation rates were higher than Māori rates for: falls (including falls on the same level from slipping, tripping and

stumbling) motorcycle riders injured in a transport accident pedal cyclists injured in a transport accident.


Length of stay and bed daysThis section includes the average number of days (length of stay) and the total number of days (bed days) spent in publicly owned facilities for hospitalisations involving injury and poisoning. It presents data for inpatients, and excludes day cases (patients hospitalised for zero days and discharged routinely). See the ‘Definitions’ section for a more detailed explanation of length of stay.

For publicly funded hospitalisations involving injury and poisoning, the average length of stay fell slightly from 8.1 days in 1995/96 to 7.9 days in 2009/10 (Table 36). The total number of bed days increased by almost 400,000 (or 57.5%) over this period.

On average, non-Māori spent longer in publicly owned facilities compared with Māori. In 1995/96, non-Māori spent 2.7 days longer in hospital compared with Māori. By 2009/10 this gap had narrowed to 2.0 days. This disparity was most evident for females: non-Māori females spent almost twice as long (on average) in hospital than Māori females (10.1 days compared with 5.4 days respectively) in 1995/96. In 2009/10, this difference had reduced to 2.7 days.

For Māori, the total number of bed days for hospitalisations involving injury and poisoning almost doubled (from 60,781 to 118,122 bed days) from 1995/96 to 2009/10. The proportion of bed days for Māori also increased over this time.

Table 36: Average length of stay and total bed days by sex and ethnicity, hospital discharges involving injury and poisoning, 1995/96 and 2009/10

Population 1995/96 2009/10



Māori 6.1 5.4 5.8 6.1 6.3 6.2

Non-Māori 7.2 10.1 8.5 7.4 9.0 8.2

Total 7.0 9.5 8.1 7.2 8.6 7.9

Bed days Bed days


Māori 38,794 21,987 60,781 66,525 51,597 118,122

Non-Māori 280,369 321,149 601,518 427,072 497,936 925,008

Total 319,163 343,136 662,299 493,597 549,533 1,043,130

Percent of total bed days Percent of total bed days


Māori 12.2 6.4 9.2 13.5 9.4 11.3


Non-Māori 87.8 93.6 90.8 86.5 90.6 88.7

Total 100.0 100.0 100.0 100.0 100.0 100.0


The following figures show the average length of stay (Figure 58) and the total number of bed days (Figure 59) for hospitalisations involving injury and poisoning by deprivation quintile. In 2009/10, the average length of stay was: longest for patients in the second most deprived (fourth) quintile (8.5

days) shortest for patients in the most deprived quintile (7.3 days).

Figure 58: Average length of stay by deprivation quintile, hospital discharges involving injury and poisoning, 2009/10

7.4

8.18.3

8.5

7.3

0

2

4

6

8

10

1 least deprived 2 3 4 5 most deprived


Average length of stay (days)



In 2009/10, the total number of days spent in publicly owned facilities for hospitalisations involving injury and poisoning was: highest in the second most deprived (fourth) quintile (267,679 bed days) lowest in the least deprived quintile (139,166 bed days).

Figure 59: Total bed days by deprivation quintile, hospital discharges involving injury and poisoning, 2009/10

139,166

167,699

221,025

267,679

240,875

0

50,000

100,000

150,000

200,000

250,000

300,000

1 least deprived 2 3 4 5 most deprived


Average length of stay (days)



Table 37 shows the average length of stay and total number of bed days for hospitalisations involving injury and poisoning by DHB region of residence. Of all DHB regions, South Canterbury had the longest average length of stay (11.9 days) in 2009/10, while Whanganui had the shortest (5.7 days). Auckland had the highest number of bed days (132,237), while Wairarapa had the lowest (8480).

Compared to New Zealand as a whole: all six South Island DHB regions had a longer average length of stay five North Island DHB regions had a longer average length of stay

(Capital & Coast, Auckland, Bay of Plenty, Waikato and MidCentral).

Table 37: Average length of stay and total bed days by DHB region, total population, hospital discharges involving injury and poisoning, 2009/10



Northland 6.0 6.2 6.1 19,000 15,285 34,285

Waitemata 6.0 7.9 6.9 52,512 64,078 116,590

Auckland 8.8 10.4 9.5 62,510 69,727 132,237


Waikato 7.7 8.5 8.0 42,579 42,754 85,333

Lakes 5.4 6.2 5.8 11,521 10,738 22,259

Bay of Plenty 7.4 8.9 8.1 27,779 28,993 56,772

Tairawhiti 6.0 6.5 6.2 5888 5397 11,285

Hawke’s Bay 6.8 7.9 7.3 16,172 15,419 31,591

Taranaki 6.3 7.6 6.9 11,079 11,477 22,556

MidCentral 7.1 8.7 7.9 15,507 19,871 35,378

Whanganui 5.2 6.3 5.7 6018 6150 12,168

Capital & Coast 10.4 10.2 10.3 34,731 39,485 74,216

Hutt Valley 7.3 8.2 7.7 12,670 14,098 26,768

Wairarapa 5.1 7.4 6.1 3823 4657 8480

Nelson Marlborough 7.6 8.7 8.1 15,591 15,981 31,572

West Coast 6.3 10.9 8.4 3594 5041 8635

Canterbury 6.9 9.8 8.3 49,866 73,096 122,962

South Canterbury 13.8 10.2 11.9 10,585 8505 19,090

Otago 8.1 9.5 8.8 26,838 30,931 57,769

Southland 9.1 10.6 9.8 16,808 15,850 32,658


Total New Zealand 7.2 8.6 7.9 493,597 549,533 1,043,130



Table 38 shows that Māori patients residing in the Capital & Coast DHB region stayed longer in hospital (10.7 days on average) than other DHB regions for hospitalisations involving injury and poisoning in 2009/10. Māori patients residing in the Wairarapa DHB region had the shortest average length of stay (4.3 days). Of all DHB regions, Waikato had the highest number of bed days for hospitalisations involving injury and poisoning for Māori (14,775), while South Canterbury had the lowest (319).

Compared to New Zealand as a whole: three South Island DHB regions had a longer average length of stay

(Otago, Southland and Canterbury) four North Island DHB regions had a longer average length of stay

(Capital & Coast, Auckland, Waikato and Taranaki).

Table 38: Average length of stay and total bed days by DHB region, Māori population, hospital discharges involving injury and poisoning, 2009/10



Northland 5.3 6.2 5.7 5718 4811 10,529

Waitemata 5.9 4.4 5.2 5841 3167 9008

Auckland 8.4 8.3 8.4 6191 5047 11,238

Counties Manukau 5.7 4.9 5.3 8281 5753 14,034

Waikato 7.0 6.8 6.9 8410 6365 14,775

Lakes 5.1 6.3 5.6 3572 3270 6842

Bay of Plenty 5.7 6.0 5.8 5301 3868 9169

Tairawhiti 5.6 6.1 5.8 2666 2235 4901

Hawke’s Bay 5.5 5.0 5.3 3577 2035 5612

Taranaki 6.3 6.9 6.5 1712 1159 2871

MidCentral 5.7 5.1 5.5 1895 1224 3119

Whanganui 4.9 5.9 5.4 1186 1229 2415

Capital & Coast 9.8 11.7 10.7 3541 4432 7973

Hutt Valley 6.0 6.3 6.1 2008 1427 3435

Wairarapa 3.5 5.6 4.3 384 381 765

Nelson Marlborough 3.7 5.9 4.8 422 679 1101

West Coast 5.6 4.1 5.0 261 114 375

Canterbury 6.2 6.5 6.4 2799 2246 5045

South Canterbury 3.6 8.0 5.1 143 176 319

Otago 5.1 10.8 7.5 879 1353 2232


Southland 8.4 5.5 7.4 1596 493 2089


Total New Zealand 6.1 6.3 6.2 66,525 51,597 118,122


Inpatients and day casesThis section presents hospitalisations involving injury and poisoning by patient type: inpatients and day cases. For this publication a day case is defined as a patient hospitalised for zero days and discharged routinely. An inpatient is a patient that does not fit the day case criteria. See the ‘Definitions’ section for more detailed explanations of inpatients and day cases.

In 2009/10, day cases made up 26.5% (47,678) of hospitalisations involving injury and poisoning: the remaining three-quarters were inpatients (Table 39). The number of day case hospitalisations in 2009/10 was more than four times higher than in 1995/96 (11,044 compared with 47,678). Some of this increase is due to some DHBs reporting short-stay emergency department events that were previously considered outpatient events.

As a proportion of all hospitalisations involving injury and poisoning, day cases more than doubled from 1995/96 to 2009/10: from 12.0% to 26.5%.

Table 39: Hospital discharges involving injury and poisoning by patient type,1995/96–2009/10

Year Inpatient Day case Percent day cases

1995/96 81,302 11,044 12.0

1996/97 86,417 11,634 11.9

1997/98 91,946 13,193 12.5

1998/99 93,753 15,437 14.1

1999/00 99,038 18,622 15.8

2000/01 106,505 24,382 18.6

2001/02 106,767 27,266 20.3

2002/03 109,620 26,079 19.2

2003/04 111,146 26,723 19.4

2004/05 112,817 30,003 21.0

2005/06 118,531 33,626 22.1

2006/07 120,924 35,519 22.7

2007/08 122,577 36,335 22.9

2008/09 126,723 45,275 26.3


2009/10 132,364 47,678 26.5


Figure 60 shows age-specific rates for inpatient and day case hospitalisations involving injury and poisoning in 2009/10. For all age groups the inpatient rate was higher than the corresponding day case rate. Those aged 85 years and over had both the highest inpatient rate (21,573.7 per 100,000 people) and the highest day case rate (2532.5 per 100,000) in 2009/10.

The difference between inpatient and day case rates increased with age; specifically the inpatient rate was: approximately 1.5 times the day case rate for those aged 0–24 years 8.5 times the day case rate for those aged 85 years and over.

Figure 60: Age-specific rates for hospital discharges involving injury and poisoning by patient type, 2009/10

0

5,000

10,000

15,000

20,000

25,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)

Inpatient Day case

Age-specific rate




Figure 61 shows inpatient rates for hospitalisations involving injury and poisoning by five-year age group and ethnicity for 2009/10. The rate of inpatient hospitalisations was greater for Māori than non-Māori for all age groups except for those aged 80 years and over. In particular, the inpatient rate for Māori was over 1.5 times the rate for non-Māori for those aged 25–69 years.


Figure 61: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, inpatients, 2009/10

0

5,000

10,000

15,000

20,000

25,000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)


Age-specific rate




Figure 62 shows day case rates for hospitalisations involving injury and poisoning by five-year age group and ethnicity for 2009/10. The day case rate was greater for Māori aged 15–74 years compared with non-Māori. The highest rate for Māori was for those aged 20–24 years (1828.5 per 100,000 Māori), while for non-Māori the highest rate was for those aged 85 years and over (2547.7 per 100,000 non-Māori).


Figure 62: Age-specific rates for hospital discharges involving injury and poisoning by ethnicity, inpatients, 2009/10

0

500

1000

1500

2000

2500

3000

0–4 5–9 10–14 15–19 20–24 25–29 30–34 35–39 40–44 45–49 50–54 55–59 60–64 65–69 70–74 75–79 80–84 85+

Age group (years)


Age-specific rate




Figure 63 shows rates for publicly funded hospitalisations involving injury and poisoning by deprivation quintile and patient type for 2009/10. Controlling for differences in age distribution, inpatient and day case rates increased as deprivation increased. At all levels of deprivation, the rate for inpatient hospitalisations was greater than the rate for day cases. This disparity was greatest in the most deprived areas of New Zealand, where the rate for inpatients was almost 2.5 times the rate for day cases.

Figure 63: Hospital discharges involving injury and poisoning by deprivation quintile and patient type, 2009/10

0

1000

2000

3000

4000



Inpatient Day case





Further hospital-related informationElectronic version of this Hospital Events publicationElectronic copies of this publication series (in PDF and Word format) are available at: www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/hospital-event-data-and-stats

Statistical hospital data tables are available online in Excel format alongside the Hospital Events publication.

These tables contain hospital event data by deprivation quintile, average length of stay, bed days, inpatients and day cases. Population denominators are also provided at national, regional, ethnic and deprivation quintile levels.

Other hospital-related Ministry of Health publications Further detailed information on numbers of hospital discharges, hospital

procedures and hospital discharges involving injury and poisoning are released in the annual online hospital data sets Publicly funded hospital discharges and Privately funded hospital discharges (www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/hospital-event-data-and-stats).

Information on hospital surgical activity data can be found in the quarterly Hospital Surgical Activity series (www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/hospital-surgical-activity-data-and-stats).


http://www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/hospital-surgical-activity-data-and-stats



http://www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/hospital-event-data-and-stats




Other publications containing data from the National Minimum DatasetOther Ministry of Health publications that report data from the NMDS are:

New Zealand Maternity Clinical Indicators, Maternity Factsheet and Maternity Snapshot, Report on Maternity serieswww.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/maternity-and-newborn-data-and-stats

Suicide Facts: Deaths and Intentional Self-harm Hospitalisations serieswww.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/suicide-data-and-stats

Mortality and Demographic Data serieswww.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/mortality-data-and-stats

These publications, and others produced by the Ministry of Health, can all be found through www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets

Other hospital-related publicationsSerious injury outcome indicator reportsStatistics New Zealand produces the annual Serious Injury Outcome Indicator reports. These indicators cover only a subset of the hospitalisation data held within this publication and cannot be directly compared.

For more information and access to the indicator technical report, please see this web page: www.stats.govt.nz/browse_for_stats/health/injuries/serious-injury-outcome-indicators-reports.aspx

If you require further information relating to the methodology, classifications and processes used, and how they differ between publications, please contact [email protected]

Population and demographic dataFor population and other demographic data contact the Ministry of Health(email: [email protected]) or Statistics New Zealand (www.stats.govt.nz).


http://www.stats.govt.nz/

mailto:[email protected]

http://www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets

http://www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets

http://www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/mortality-data-and-stats

http://www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/mortality-data-and-stats

http://www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/maternity-and-newborn-data-and-stats

http://www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/maternity-and-newborn-data-and-stats

Hospital data available from the Ministry of HealthEmail: [email protected]

Item Notes

National Health Index (NHI) number

A unique patient identifier. Restricted access.

Admission source A code used to describe the nature of admission (routine or transfer) for a hospital inpatient health event.

Admission type A code used to describe the type of admission for a hospital health care event, for example arranged admission, acute admission, elective admission of a privately funded patient.

NZ resident status A code identifying resident status at the time of the event. Used to identify overseas residents treated in New Zealand. Tied to public funding of events.

Date of birth Day, month, year.

Age Age in years.

Sex Male, female, indeterminate, unknown.

Ethnicity Based on Statistics New Zealand Standard Classification 1996 (Level 2), for example NZ Māori, NZ European or Pakeha, Other European, Samoan, Chinese and so on. Up to three ethnicities are recorded and prioritised.

Domicile code Based on Statistics New Zealand Standard Area Unit code. Represents a person’s usual residential address.

Event type A code identifying the type of health event, for example birth event, day patient, death event, psychiatric inpatient event, outpatient event.

Event end type A code identifying how a health care event ended. For example, discharge to an acute facility, ended routinely, routine discharges from an emergency department acute facility.

Event start date The admission date on which a health care event began.

Event end date The date on which a health care user is discharged from a facility (ie, the date the health care event ended) or the date on which a sectioned mental health patient is discharged to leave.

Event local identifier Local system-generated number to distinguish two or more events of the same type occurring on the same day at the same facility.

Event ID An internal reference number that uniquely identifies a health event.

Event leave days The number of days an inpatient on leave is absent from the hospital at midnight, up to a maximum of three days (midnights) for non-psychiatric hospital inpatients for any one leave episode.

Diagnosis code(s) A code used to classify the clinical description of a diagnosis. Codes are from the World Health Organization International Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM). Up to 99 codes may be recorded.

Accident/ecode(s) A code used to classify the clinical description of a cause of an accident (involving injury and poisoning. Codes are from the World Health Organization International Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM).

Accident date The date when the accident/injury occurred.



Item Notes

Procedure code(s) A code used to classify the clinical description of a procedure. Codes are from the World Health Organization International Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM). Up to 99 codes may be recorded.

Procedure date(s) The date the procedure was performed.

Agency code A code that uniquely identifies an agency. An agency is an organisation, institution or group of institutions that contracts directly with the principal health service purchaser to deliver health care services to the community.

Facility code A code that uniquely identifies a health care facility.

Facility type A code that categorises facilities into particular types, for example public hospital, private hospital, psychiatric hospital, GP practice, health centre, drug and alcohol treatment facility.

Specialty code The speciality from which the patient was discharged.

Purchaser code A code for the organisation or body that purchased the health care service provided.

DRG code A diagnosis-related group (DRG) code produced by the DRG grouper program. Provides another way of analysing event information based on classifying episodes of inpatient care into clinically meaningful groups with similar resource consumption.

Additional information available from the Ministry of HealthYou may require information not included in this report or in the online statistical tables. The Ministry of Health is able to produce customised data extracts tailored to your needs. These may incur a charge (at Official Information Act rates). If you require additional data or analysis, please contact:

Analytical ServicesMinistry of HealthPO Box 5013WellingtonNew Zealand

Ph: (04) 496 2000Fax: (04) 816 2898Email: [email protected] visit: www.health.govt.nz

The Ministry of Health welcomes comments and suggestions about this publication.



DefinitionsAge-specific rates Refer to the ‘Technical notes’ section.

Age-standardised rates

Refer to the ‘Technical notes’ section.

Day case (day patient)

A person who is admitted to hospital and discharged routinely on the same day. Day cases do not include those patients who died in hospital or transferred to another hospital; these are considered inpatients.

District health board (DHB) region of residence

District health boards are body corporates owned by the Crown. They are responsible for providing or buying government-funded health care services for the population of a specific geographical area. This publication presents hospital data by DHB region of residence. Note that not all residents in a particular DHB will be treated in that DHB region.

Ethnicity Two ethnic groupings are used in this publication: Māori and non-Māori. The Māori population includes everyone who identified as Māori, and the non-Māori population includes everyone else.

This publication uses ‘prioritised ethnicity’, where each person is allocated to one ethnic group using the priority system Māori > non-Māori (Ministry of Health 2004). The aim of prioritisation is to ensure that when it is necessary to assign people to a single ethnic group, ethnic groups that are small or important in terms of policy are not swamped by the European ethnic group (Ministry of Health 2004). This method is also a more robust method of dealing with the low rate of multiple ethnicities in health sector data.

The system recognises certain key characteristics of ethnicity: ethnicity is self-perceived, so people should identify

their ethnic affiliation themselves wherever feasible a person can belong to more than one ethnic group the ethnicities with which a person identifies can

change over time.

Event An admission and discharge from a hospital.


Hospital discharge Discharge occurs when a patient leaves hospital to return home, transfers to another hospital or residential institution, or dies in hospital after formal admission. In this publication, discharges are equivalent to the number of patients discharged, transferred from or dying in publicly or privately funded hospitals.

Inpatient A person who is admitted to hospital for medical, surgical, psychiatric or obstetric treatment, observation or care and who stays at least one night. ‘Inpatient’ also includes healthy persons if formally admitted by the hospital as ‘boarders’, and patients who die in hospital or who are transferred to another hospital on the day of admission.

Intentional self-harm Rates for intentional self-harm in this publication are defined using intentional self-harm external cause codes (X60–X84) from the ICD-10-AM. It is important to note that reported rates for intentional self-harm in this publication are not directly comparable with those reported in the Ministry of Health’s recent Suicide Facts: Deaths and intentional self-harm hospitalisations publications. The underlying data have been selected and filtered in different ways, and are reported for different time periods (calendar years versus financial years). For example, the rates reported in the Suicide Facts publication exclude short-stay emergency department admissions. Refer to the Suicide Facts: Deaths and intentional self-harm hospitalisations series for further detail.

International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification, 6th Edition (ICD-10-AM)

The ICD-10-AM is used to classify causes of morbidity throughout this publication (National Centre for Classification in Health 2008).

ICD-10-AM codes are based on the official version of the WHO’s International Classification of Diseases and Related Health Problems. Codes are designed for classification of morbidity and mortality information for statistical purposes. ICD codes are also used for indexing hospital records by disease and operations, for data storage and retrieval. The clinical codes are used to classify the clinical description of a condition, cause of intentional and unintentional injury, underlying cause of death, operation or procedure performed or pathological nature of a tumour.

Length of stay Equates to midnights spent in hospital. It is reported in days and calculated from the start date to the end date (less any leave days) of a hospital event.


National Minimum Dataset (NMDS)

A national collection of public and private hospital discharge information, including clinical information for inpatients and day patients (National Health Board Business Unit 2010).

New Zealand Index of Deprivation 2006 (NZDep2006)

The New Zealand Deprivation Index is a measure of socioeconomic status calculated for small geographic areas. The calculation combines nine variables that reflect aspects of social and material deprivation from the 2006 Census of Population and Dwellings. The Deprivation Index is calculated at the level of meshblocks (geographical units containing a median of 90 people), and the Ministry of Health maps these to domicile codes, which are built up to the relevant geographic scale using weighted average, usually resident population counts from the Census. The nine variables in the index, by decreasing weight, are:1 income: people aged 18–6421 receiving a means-

tested benefit2 income: people living in an equivalised22 household

with income below an income threshold3 home ownership: people not living in their own home4 support: people aged under 65 living in a single-

parent family5 employment: people aged 18–64 who are

unemployed6 qualifications: people aged 18–64 with no

qualifications7 living space: people living in an equivalised22

household below a bedroom occupancy threshold8 communication: people with no access to a

telephone9 transport: people with no access to a car.

The index scores are grouped into 10 deciles, with each decile representing an equal or similar size of the New Zealand population.

For the purposes of this publication the 10 deciles have been combined into five quintiles. Quintile 1 (deciles 1 and 2) represents the least deprived areas and quintile 5 (deciles 9 and 10) the most deprived areas.

Further information is available from www.health.govt.nz; search for ‘NZDep 2006 Index of Deprivation’.

21 The upper age boundary of 64 has been increased from the NZDep2001 value of 60 to better reflect societal norms.

22 Equivalisation is a method used to control household composition.


http://www.health.govt.nz/

Procedure Procedures can be surgical or non-surgical, and can treat or diagnose a condition or provide patient support, such as anaesthesia.

Publicly funded hospital events

Health care events that are publicly funded; this includes Ministry of Health, DHB and ACC funded events. Also included are publicly funded hospital services provided in private hospitals.

Privately funded hospital events

Health care events that are privately funded; this includes insurance-funded and self-funded events. Also included are privately funded hospital services provided in public hospitals; the majority of these involve overseas residents whose country does not have a reciprocal health agreement with New Zealand (‘overseas chargeable’).


Technical notesIn this publication, numbers are generally rounded to one decimal place. However, calculations are made from the full string (that is, all the numbers after the decimal place), thereby providing more precise reporting.

Rate calculationsAge-specific rates show the number of events (for example, hospitalisations or procedures) per 100,000 people in each age group for each year. In this publication age-specific rates are given in five-year age groups. Table N-1 presents the estimated resident population of New Zealand by age, sex and ethnicity as at 30 June 2010. This population was used to calculate the rates shown in this publication.

Table N-1: Population data, 2009/10

Age group (years)

Total population Māori population


0–4 160,020 151,830 311,850 45,960 43,210 89,170

5–9 146,900 139,920 286,820 35,750 33,920 69,680

10–14 151,580 144,210 295,780 35,340 33,480 68,820

15–19 165,510 156,880 322,390 34,940 33,040 67,980

20–24 161,380 153,840 315,220 27,870 28,680 56,550

25–29 143,180 145,230 288,410 20,230 22,300 42,540

30–34 129,330 139,990 269,330 19,500 22,160 41,660

35–39 143,000 158,290 301,290 19,970 23,070 43,040

40–44 149,330 162,400 311,730 18,840 21,380 40,220

45–49 156,140 166,530 322,670 18,360 20,700 39,060

50–54 142,640 148,850 291,480 15,220 16,900 32,120

55–59 123,430 127,910 251,340 11,440 12,550 23,990

60–64 113,090 117,220 230,310 8,650 9,460 18,110

65–69 85,990 90,230 176,220 5,810 6,550 12,350

70–74 65,490 71,460 136,950 4,220 4,840 9,060

75–79 48,880 56,300 105,180 2,380 2,910 5,300

80–84 34,800 45,910 80,710 1,130 1,630 2,760

85+ 23,910 46,180 70,090 540 930 1,480

All ages 2,144,600 2,223,200 4,367,800 326,200 337,700 663,900


Source: Statistics New Zealand

Note: Because of rounding, individual figures in this table do not always sum to give the stated totals.

Age-standardised rates adjust for differences in age distribution of the populations being compared. Age-standardised rates are calculated by multiplying age-specific rates by a standard population (the direct standardisation method). They are artificially created figures that allow comparisons to be made with differing groups; they should only be compared with other adjusted rates that have been calculated using the same standard population.

The standard population used in these calculations is the WHO world standard population (Table N-2), a widely used New Zealand and international standard.

Table N-2: World Health Organization world standard population

Age group Population

0–4 8860

5–9 8690

10–14 8600

15–19 8470

20–24 8220

25–29 7930

30–34 7610

35–39 7150

40–44 6590

45–49 6040

50–54 5370

55–59 4550

60–64 3720

65–69 2960

70–74 2210

75–79 1520

80–84 910

85+ 635

Total 100,035

Source: Ahmad et al 2001


Confidence intervalsThe confidence intervals in this publication have been calculated using the methods presented in Keyfitz (1966). A confidence interval is a range of values used to describe the uncertainty around a single value (such as an age-standardised rate). Confidence intervals describe how different the estimate could have been if chance had led to a different set of data. Confidence intervals are calculated with a stated probability. For this publication, confidence intervals are calculated to a 95% probability, which indicates that there is a 95% chance that the true value lies within the confidence interval.

Confidence intervals may assist in comparing hospitalisation and procedure rates over time. If two confidence intervals do not overlap, then it is reasonable to assume that the difference is not due to chance. If they do overlap, it is not possible to draw any conclusion about the significance of any difference between them.

Procedure codesTable N-3 presents the ICD-10-AM procedures codes used to define selected procedures in the publication.

Table N-3: ICD-10-AM 6th Edition procedure codes for selected procedures

Procedure Block Procedure codes

Cataracts 195 4269800, 4270200, 4270201

196 4269801, 4270202, 4270203

197 4269802, 4270204, 4270205

198 4269803, 4270206, 4270207

199 4269804, 4270208, 4270209

200 4273101, 4269805, 4270210, 4270211

Varicose veins 727 3250800, 3250801, 3251100

728 3250401, 3250700

Grommets and myringotomies 309 4162600, 4162601, 4163200, 4163201

Hysterectomies/removal of womb

1268 9044800, 3565300, 9044801, 3565301, 9044802, 3565304, 3566100, 3567000, 3566700, 3566400

1269 3575000, 3575302, 3575600, 3575603, 3565700, 3567302, 3566701, 3566401


Procedure Block Procedure codes

Hernia 990 3060902, 3060903, 3061402, 3061403

991 3060900, 3060901, 3061400, 3061401

992 3061700, 3061701, 3061702

993 3040300, 3040500, 3040501, 3040502

994 3056302, 3056303

996 3040301, 3040503, 3040504, 3040505

997 3061500

998 3060100, 3060101, 3060000, 4383702

Coronary angioplasties 670 3830000, 3830300, 3830001, 3830301

671 3830600, 3830601, 3830602, 3830603, 3830604, 3830605

Hip replacement* 1489 4752200, 4931200, 4931500, 4931800, 4931900, 9060700, 9060701

Knee replacement* 1518 4951700, 4951800, 4951900, 4953401

1519 4952100, 4952101, 4952102, 4952103, 4952400, 4952401

Coronary artery bypass grafts 672 3849700, 3849701, 3849702, 3849703

673 3849704, 3849705, 3849706, 3849707

674 3850000, 3850300

675 3850001, 3850301

676 3850002, 3850302

677 3850003, 3850303

678 3850004, 3850304

679 9020100, 9020101, 9020102, 9020103

Prostatectomies 1165 3720300, 3720100, 3720302

1166 3720700, 3720701, 3720303, 3720304, 3720305, 3720306, 3720901, 3721001, 3721101

1167 3720003, 3720004, 3720900, 3721000, 3721100, 3720005

Tonsillectomies and adenoidectomies

412 4178900, 4180100, 4178901, 4180400

Carpal and tarsal tunnel procedures

76 3933001, 3933100, 3933101

Cholecystectomy 965 3044300, 3044500, 3044600, 3044800, 3044900, 3045401, 3045500

* Procedure codes include total and partial replacements but exclude revisions.


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http://www.stats.govt.nz/browse_for_stats/

http://www.stats.govt.nz/browse_for_stats/health/injuries/



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Documents

· Web viewHospital Events 2008/09 and 2009/10 Citation: Ministry of Health. 2012. Hospital Events 2008/09 and 2009/10. Wellington: Ministry of Health. Published in November 2012